MEDICARE: AAAIP PHARMACY CORP

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
2	3336M0002X	Mail Order Pharmacy
3	3336M0003X	Managed Care Organization Pharmacy
4	332B00000X	Durable Medical Equipment & Medical Supplies
5	3336C0004X	Compounding Pharmacy
6	3336S0011X	Specialty Pharmacy
7	3336C0003X	Community/Retail Pharmacy	027934	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	3351943	OTHER		NCPDP PROVIDER IDENTIFICATION NUMBER

General Provider Information

NPI Number	:	1851496715
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AAAIP PHARMACY CORP

Provider Business Mailing Address
First Line	:	12510 QUEENS BLVD
Second Line	:
City	:	KEW GARDENS
State	:	NY
Zip	:	11415-1519
Country	:	US
Telephone Number	:	718-520-3460
Fax Number	:	718-520-3462

Provider Business Practice Location Address
First Line	:	12510 QUEENS BLVD
Second Line	:
City	:	KEW GARDENS
State	:	NY
Zip	:	11415-1519
Country	:	US
Telephone Number	:	718-520-3460
Fax Number	:	718-520-3462

Authorized Official
Title or Position	:	PRESIDENT
Name	:	PETER NIYAZOV
Credential	:	PHARMD
Telephone Number	:	718-520-3460

Provider Enumeration Date	:	09/14/2006
Last Update Date	:	07/26/2012

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Directions to “AAAIP PHARMACY CORP ” Practice Location

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