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General NPI Number Information
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NPI Number | 1275930612
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Entity Type | Organization
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Legal Business Name | HABITAT PHARMACY, INC.
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Dates
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Enumeration Date | 12/01/2014
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Last Update Date | 12/01/2014
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Provider Practice Location Address
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Address Line | 525 3RD AVE
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City | NEW YORK
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State | NY
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Zip | 10016-4168
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Country | US
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Telephone | 212-685-8600
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Fax | 212-685-1700
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Provider Business Mailing Address
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Address Line | 525 3RD AVE PHARMACY
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City | NEW YORK
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State | NY
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Zip | 10016-4168
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Country | US
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Telephone | 212-685-8600
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Fax | 212-685-1700
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Authorized Official
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Title or Position | PHARMACIST
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Name | MS. SHERIN AYOUB
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Credential | RPH
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Telephone | 917-613-2593
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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 | 033235
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License Number State | NY
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