MEDICARE: LEXINGTON AVENUE 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	030023	NY

General Provider Information

NPI Number	:	1588988539
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LEXINGTON AVENUE PHARMACY

Provider Business Mailing Address
First Line	:	2056 LEXINGTON AVE
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10035-1732
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2056 LEXINGTON AVE
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10035-1732
Country	:	US
Telephone Number	:	212-426-5555
Fax Number	:

Authorized Official
Title or Position	:	VP
Name	:	MR. HARDY CHUNG
Credential	:
Telephone Number	:	718-742-3400

Provider Enumeration Date	:	03/19/2010
Last Update Date	:	03/19/2010

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Directions to “LEXINGTON AVENUE PHARMACY ” Practice Location

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