MEDICARE: NYCO CHEMISTS 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	3336C0003X	Community/Retail Pharmacy	028614	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	3355852	OTHER		NCPDP PROVIDER IDENTIFICATION NUMBER

General Provider Information

NPI Number	:	1588844138
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NYCO CHEMISTS INC

Provider Business Mailing Address
First Line	:	104 JAY ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11201-1569
Country	:	US
Telephone Number	:	718-246-4100
Fax Number	:	718-246-2417

Provider Business Practice Location Address
First Line	:	104 JAY ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11201-1569
Country	:	US
Telephone Number	:	718-246-4100
Fax Number	:	718-246-2417

Authorized Official
Title or Position	:	PRESIDENT
Name	:	CHRISTOS TSIOROS
Credential	:
Telephone Number	:	718-246-4100

Provider Enumeration Date	:	11/13/2007
Last Update Date	:	01/14/2011

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Directions to “NYCO CHEMISTS INC ” Practice Location

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