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General NPI Number Information
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NPI Number | 1972536456
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Entity Type | Organization
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Legal Business Name | 133RD STREET PHARMACY INC
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Dates
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Enumeration Date | 07/08/2006
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Last Update Date | 05/10/2016
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Provider Practice Location Address
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Address Line | 1473 AMSTERDAM AVE
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City | NEW YORK
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State | NY
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Zip | 10027-7472
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Country | US
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Telephone | 212-491-4911
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Fax | 212-491-4916
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Provider Business Mailing Address
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Address Line | 1473 AMSTERDAM AVE
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City | NEW YORK
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State | NY
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Zip | 10027-7472
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Country | US
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Telephone | 212-491-4911
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Fax | 212-491-4916
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Authorized Official
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Title or Position | SUP PHARMACIST
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Name | BHARGAV PATEL
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Credential | RPH
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Telephone | 212-491-4911
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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 | 027564
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License Number State | NY
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