MEDICARE: NEERGAARD NYC 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	333600000X	Pharmacy

General Provider Information

NPI Number	:	1659716413
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEERGAARD NYC INC

Provider Business Mailing Address
First Line	:	1520 1ST AVE
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10075-1024
Country	:	US
Telephone Number	:	212-327-4700
Fax Number	:	212-327-4700

Provider Business Practice Location Address
First Line	:	1520 1ST AVE
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10075-1024
Country	:	US
Telephone Number	:	212-327-4700
Fax Number	:	212-327-4700

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. THOMAS SUTHERLAND
Credential	:	RPH
Telephone Number	:	212-327-4700

Provider Enumeration Date	:	05/07/2013
Last Update Date	:	05/07/2013

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