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General NPI Number Information
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NPI Number | 1447268107
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Entity Type | Organization
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Legal Business Name | 10 PARK PHARMACY INC.
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Dates
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Enumeration Date | 08/04/2006
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Last Update Date | 07/30/2007
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Provider Practice Location Address
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Address Line | 53 E 34TH ST
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City | NEW YORK
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State | NY
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Zip | 10016-4332
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Country | US
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Telephone | 212-683-3838
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Fax | 212-679-3123
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Provider Business Mailing Address
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Address Line | 53 E 34TH ST
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City | NEW YORK
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State | NY
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Zip | 10016-4332
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Country | US
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Telephone | 212-683-3838
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Fax | 212-679-3123
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Authorized Official
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Title or Position | PRESIDENT/PHARMACIST
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Name | MR. LEON TARASENKO
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Credential | RPH
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Telephone | 212-683-3838
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 019404
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License Number State | NY
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