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General NPI Number Information
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NPI Number | 1972925907
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Entity Type | Organization
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Legal Business Name | 543 LENOX CORP
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Dates
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Enumeration Date | 01/10/2014
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Last Update Date | 02/27/2015
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Provider Practice Location Address
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Address Line | 543 LENOX AVE
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City | NEW YORK
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State | NY
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Zip | 10037-1806
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Country | US
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Telephone | 212-283-2136
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Fax | 212-283-2463
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Provider Business Mailing Address
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Address Line | 543 LENOX AVE
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City | NEW YORK
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State | NY
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Zip | 10037-1806
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Country | US
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Telephone | 212-283-2136
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Fax | 212-283-2463
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Authorized Official
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Title or Position | OWNER
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Name | MOHAMED HASSAN
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Credential |
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Telephone | 212-283-2136
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 032856
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License Number State | NY
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