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General NPI Number Information
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NPI Number | 1265758346
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Entity Type | Organization
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Legal Business Name | HYDE PARK PHARMACY INC
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Dates
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Enumeration Date | 04/14/2010
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Last Update Date | 04/13/2011
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Provider Practice Location Address
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Address Line | 870 VIOLET AVE STE 10
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City | HYDE PARK
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State | NY
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Zip | 12538-1754
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Country | US
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Telephone | 845-229-5599
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Fax | 845-229-5523
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Provider Business Mailing Address
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Address Line | 870 VIOLET AVE STE 10
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City | HYDE PARK
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State | NY
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Zip | 12538-1754
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Country | US
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Telephone | 845-229-5599
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Fax | 845-229-5523
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | MR. ABBAS HAYAT LODHI
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Credential | RPH
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Telephone | 845-229-5599
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | 042577
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License Number State | NY
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