MEDICARE: NYU STUDENT HEALTH CENTER PHARMACY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	333600000X	Pharmacy	023424	NY

General Provider Information

NPI Number	:	1184712028
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NYU STUDENT HEALTH CENTER PHARMACY

Provider Business Mailing Address
First Line	:	726 BROADWAY
Second Line	:	4TH FLOOR
City	:	NEW YORK
State	:	NY
Zip	:	10003-9502
Country	:	US
Telephone Number	:	212-443-1050
Fax Number	:	212-443-1051

Provider Business Practice Location Address
First Line	:	726 BROADWAY
Second Line	:	4TH FLOOR
City	:	NEW YORK
State	:	NY
Zip	:	10003-9502
Country	:	US
Telephone Number	:	212-443-1050
Fax Number	:	212-443-1051

Authorized Official
Title or Position	:	PHARMACIST IN CHARGE
Name	:	CHRIS KA PAK
Credential	:
Telephone Number	:	212-443-1050

Provider Enumeration Date	:	10/10/2006
Last Update Date	:	09/11/2013

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