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General NPI Number Information
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NPI Number | 1952440901
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Entity Type | Organization
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Legal Business Name | 1491 LEX PHARMACY INC
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Dates
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Enumeration Date | 02/06/2007
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Last Update Date | 02/29/2008
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Provider Practice Location Address
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Address Line | 1491 LEXINGTON AVE
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City | NEW YORK
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State | NY
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Zip | 10029
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Country | US
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Telephone | 212-289-3665
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Fax | 212-289-3995
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Provider Business Mailing Address
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Address Line | 1491 LEXINGTON AVE
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City | NEW YORK
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State | NY
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Zip | 10029
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Country | US
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Telephone | 212-289-3665
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Fax | 212-289-3995
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Authorized Official
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Title or Position | PHARMACY SERVICES
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Name | LIZETTE ROZARIO
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Credential | CPHT
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Telephone | 212-289-3665
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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 | 027656
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License Number State | NY
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