{
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"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "MIDLAND PHARMACY YONKERS CORP.",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
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"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "861 MIDLAND AVE",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "YONKERS",
"MailingAddressStateName": "NY",
"MailingAddressPostalCode": "10704-1024",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "914-968-0349",
"MailingAddressFaxNumber": "914-968-0357",
"FirstLinePracticeLocationAddress": "861 MIDLAND AVE",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "YONKERS",
"PracticeLocationAddressStateName": "NY",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "914-968-0349",
"PracticeLocationAddressFaxNumber": "914-968-0357",
"EnumerationDate": "08/02/2022",
"LastUpdateDate": "09/09/2025",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "DEZORAIEV",
"AuthorizedOfficialFirstName": "BINYAMIN",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "OWNER",
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"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "914-968-0349",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "3336S0011X",
"TaxonomyName": "Specialty Pharmacy",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "3336C0003X",
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"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}