MEDICARE: NY CITY 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

General Provider Information

NPI Number	:	1427289172
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NY CITY PHARMACY

Provider Business Mailing Address
First Line	:	2260 3RD AVE
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10035-2208
Country	:	US
Telephone Number	:	347-739-2840
Fax Number	:

Provider Business Practice Location Address
First Line	:	2260 3RD AVE
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10035-2208
Country	:	US
Telephone Number	:	347-739-2840
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	BETTY GRULLON
Credential	:
Telephone Number	:	347-739-2841

Provider Enumeration Date	:	07/29/2009
Last Update Date	:	12/09/2012

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Directions to “NY CITY PHARMACY ” Practice Location

Language	Start Address	Practice Location

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