Provider Demographics
NPI:1609912088
Name:NYC PHARMACY INC
Entity type:Organization
Organization Name:NYC PHARMACY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:HIN
Authorized Official - Middle Name:TAT
Authorized Official - Last Name:WONG
Authorized Official - Suffix:I
Authorized Official - Credentials:PHARMACIST
Authorized Official - Phone:212-369-8082
Mailing Address - Street 1:203 E 121ST ST
Mailing Address - Street 2:STORE# 2
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10035-3018
Mailing Address - Country:US
Mailing Address - Phone:212-369-8082
Mailing Address - Fax:212-369-8083
Practice Address - Street 1:203 E 121ST ST
Practice Address - Street 2:STORE# 2
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10035-3018
Practice Address - Country:US
Practice Address - Phone:212-369-8082
Practice Address - Fax:212-369-8083
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-30
Last Update Date:2013-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY025666333600000X, 3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY3330141OtherNCPDP
NY02380367Medicaid
NY6789920001Medicare NSC