MEDICARE: BLONDELL RX NY LLC

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	3336L0003X	Long Term Care Pharmacy

General Provider Information

NPI Number	:	1356965636
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BLONDELL RX NY LLC

Provider Business Mailing Address
First Line	:	1047 SURF AVE FL 2
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11224-2810
Country	:	US
Telephone Number	:	917-830-2522
Fax Number	:	917-722-0851

Provider Business Practice Location Address
First Line	:	1642 EASTCHESTER RD
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10461-2316
Country	:	US
Telephone Number	:	347-691-3494
Fax Number	:	347-691-3496

Authorized Official
Title or Position	:	PIC
Name	:	GARI BASIN
Credential	:
Telephone Number	:	347-691-3494

Provider Enumeration Date	:	06/03/2020
Last Update Date	:	10/04/2023

Similar Medicare Providers

1003148321 — BLONDELL RX NY LLC
Practice Location Address:

1642 EASTCHESTER RD
BRONX, NY
10461-2316

Practice Phone: 347-691-3494
Practice Fax: 347-961-3496

1568152106 — MICHAEL ISKHAKOV
Practice Location Address:

1644 EASTCHESTER RD
BRONX, NY
10461-2316

Practice Phone: 917-445-9119
Practice Fax:

1205854940 — JEROME NORTON PSY.D
Practice Location Address:

2316 BRUNER AVE
BRONX, NY
10469-6323

Practice Phone: 718-652-2461
Practice Fax:

1821149055 — GOLD CREST CARE CENTER INC.
Practice Location Address:

2316 BRUNER AVE
BRONX, NY
10469-6323

Practice Phone: 718-882-6400
Practice Fax:

1932344140 — JOANNE O'BEIRNE
Practice Location Address:

2316 BRUNER AVE.
BRONX, NY
10469-1952

Practice Phone: 718-496-0136
Practice Fax:

1013339845 — KHIEMA MILLS
Practice Location Address:

1210 WHEELER AVE APT 3
BRONX, NY
10472-2316

Practice Phone: 340-473-7263
Practice Fax:

Directions to “BLONDELL RX NY LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.