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General NPI Number Information
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NPI Number | 1285394940
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Entity Type | Organization
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Legal Business Name | PMY, LLC
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Dates
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Enumeration Date | 12/22/2021
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Last Update Date | 12/22/2021
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Provider Practice Location Address
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Address Line | 419 FOREST AVE
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City | STATEN ISLAND
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State | NY
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Zip | 10301-2623
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Country | US
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Telephone | 917-444-1588
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Fax | 917-444-1589
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Provider Business Mailing Address
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Address Line | 419 FOREST AVE
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City | STATEN ISLAND
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State | NY
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Zip | 10301-2623
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Country | US
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Telephone | 917-444-1588
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Fax | 917-444-1589
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | PETER MESHREKY
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Credential |
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Telephone | 917-444-1588
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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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