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General NPI Number Information
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NPI Number | 1144883745
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Entity Type | Organization
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Legal Business Name | SIDNEY PHARMACY INC
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Dates
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Enumeration Date | 04/18/2019
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Last Update Date | 05/23/2019
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Provider Practice Location Address
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Address Line | 122 GRAMATAN AVE
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City | MT VERNON
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State | NY
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Zip | 10550-1206
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Country | US
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Telephone | 914-371-1967
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Fax |
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Provider Business Mailing Address
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Address Line | 30 WESTMINSTER CT
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City | NEW ROCHELLE
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State | NY
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Zip | 10801-3107
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Country | US
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Telephone | 914-837-7823
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Fax |
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Authorized Official
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Title or Position | PHARMACIST
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Name | MR. CHRISTIAN OGAGA
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Credential |
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Telephone | 914-837-7823
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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