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NPI 1760497374

NPI 1760497374 : LINDENVIEW RAINDEW CORP : FLUSHING, NY

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General NPI Number Information
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    NPI Number           |    1760497374
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    Entity Type          |    Organization 
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    Legal Business Name  |    LINDENVIEW RAINDEW CORP 
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Dates
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    Enumeration Date     |    07/30/2006
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    Last Update Date     |    03/10/2011
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Provider Practice Location Address
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    Address Line         |    25 39 PARSONS BLVD 
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    City                 |    FLUSHING
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    State                |    NY
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    Zip                  |    11354-1296
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    Country              |    US
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    Telephone            |    718-762-8041
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    Fax                  |    718-762-8130
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Provider Business Mailing Address
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    Address Line         |    25 39 PARSONS BLVD 
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    City                 |    FLUSHING
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    State                |    NY
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    Zip                  |    11354-1296
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    Country              |    US
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    Telephone            |    718-762-8041
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    Fax                  |    718-762-8130
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Authorized Official
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    Title or Position    |    SP
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    Name                 |     JOEL  BASSUK 
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    Credential           |    
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    Telephone            |    718-762-8041
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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       |    
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    License Number State |    
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Taxonomy #2
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    Taxonomy Code        |    3336C0003X
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    Taxonomy Name        |    Community/Retail Pharmacy
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    License Number       |    021484
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    License Number State |    NY
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