Provider Demographics
NPI:1609811462
Name:UNIONDALE CHEMISTS, INC.
Entity type:Organization
Organization Name:UNIONDALE CHEMISTS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:
Authorized Official - Last Name:CANTALINO
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:516-486-4333
Mailing Address - Street 1:546 UNIONDALE AVE
Mailing Address - Street 2:
Mailing Address - City:UNIONDALE
Mailing Address - State:NY
Mailing Address - Zip Code:11553-2202
Mailing Address - Country:US
Mailing Address - Phone:516-486-4333
Mailing Address - Fax:516-486-0464
Practice Address - Street 1:546 UNIONDALE AVE
Practice Address - Street 2:
Practice Address - City:UNIONDALE
Practice Address - State:NY
Practice Address - Zip Code:11553-2202
Practice Address - Country:US
Practice Address - Phone:516-486-4333
Practice Address - Fax:516-486-0464
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-17
Last Update Date:2008-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY022983183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01660177Medicaid
NY1195980001Medicare NSC