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General NPI Number Information
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NPI Number | 1942311329
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Entity Type | Organization
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Legal Business Name | KINGS PARK SLOPE LLC
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 03/04/2025
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Provider Practice Location Address
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Address Line | 8 E 41ST ST
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City | NEW YORK
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State | NY
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Zip | 10017-0040
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Country | US
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Telephone | 718-230-3535
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Fax | 718-230-0596
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Provider Business Mailing Address
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Address Line | 8 E 41ST ST
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City | NEW YORK
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State | NY
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Zip | 10017-0040
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Country | US
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Telephone | 718-230-3535
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Fax | 718-230-0596
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Authorized Official
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Title or Position | CEO
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Name | JAMES TEDORI
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Credential |
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Telephone | 718-230-3535
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251F00000X
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Taxonomy Name | Home Infusion Agency
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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 |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 3336C0004X
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Taxonomy Name | Compounding Pharmacy
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 3336M0002X
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Taxonomy Name | Mail Order Pharmacy
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 3336S0011X
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Taxonomy Name | Specialty Pharmacy
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 32971
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License Number State | NY
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