=====================================================
General NPI Number Information
=====================================================
NPI Number | 1982621298
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | STANLEY GETTY CORP.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/16/2006
-----------------------------------------------------
Last Update Date | 08/20/2012
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2 S BROADWAY
-----------------------------------------------------
City | YONKERS
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10701-3702
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 914-476-6060
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2 S BROADWAY
-----------------------------------------------------
City | YONKERS
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10701-3702
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 914-476-6060
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | GENERAL MANAGER
-----------------------------------------------------
Name | MR. JI Y LEE
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 914-476-6060
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 333600000X
-----------------------------------------------------
Taxonomy Name | Pharmacy
-----------------------------------------------------
License Number | 007800
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------