MEDICARE: N&B PHARMACY INC

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	183500000X	Pharmacist	025513	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1184769051
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	N&B PHARMACY INC

Provider Business Mailing Address
First Line	:	11829A METROPOLITAN AVE
Second Line	:
City	:	KEW GARDENS
State	:	NY
Zip	:	11415-2020
Country	:	US
Telephone Number	:	718-487-8100
Fax Number	:	718-487-8300

Provider Business Practice Location Address
First Line	:	118-29A METROPOLITAN AVE
Second Line	:
City	:	KEW GARDENS
State	:	NY
Zip	:	11415-2020
Country	:	US
Telephone Number	:	718-487-8100
Fax Number	:	718-487-8300

Authorized Official
Title or Position	:	PHARMACIST
Name	:	NATELLA FAZYLOV
Credential	:	RPH
Telephone Number	:	718-487-8100

Provider Enumeration Date	:	02/20/2007
Last Update Date	:	09/13/2011

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Directions to “N&B PHARMACY INC ” Practice Location

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