MEDICARE: NYRX AT RALPH 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	3336C0003X	Community/Retail Pharmacy

General Provider Information

NPI Number	:	1467134312
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NYRX AT RALPH LLC

Provider Business Mailing Address
First Line	:	820 WYCKOFF AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11237-6005
Country	:	US
Telephone Number	:	718-456-3156
Fax Number	:	718-417-7159

Provider Business Practice Location Address
First Line	:	820 WYCKOFF AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11237-6005
Country	:	US
Telephone Number	:	718-456-3156
Fax Number	:	718-417-7159

Authorized Official
Title or Position	:	OWNER
Name	:	ALI RAZA
Credential	:
Telephone Number	:	718-456-3156

Provider Enumeration Date	:	08/01/2023
Last Update Date	:	02/17/2026

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Directions to “NYRX AT RALPH LLC ” Practice Location

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