# LYDIG AVENUE PHARMACY CORP.

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1225154339
- **Authorized official:** MRS. LYUDMILA SHALOM RPH (PHARMACIST)
- **Authorized official phone:** (718) 678-8700

## Contact information

- **Practice address:** 742 LYDIG AVE, BRONX, NY 10462-2104
- **Practice address phone:** (718) 678-8700
- **Practice address fax:** (718) 678-8777
- **Mailing address:** 742 LYDIG AVE, BRONX, NY 10462-2104
- **Mailing address phone:** (718) 678-8700
- **Mailing address fax:** (718) 678-8777

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | Yes |
| 3336C0003X | Community/Retail Pharmacy | — | NY | — |

## Other

- **Enumeration date:** 03/21/2007
- **Last updated:** 10/15/2007

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 02397304 | — | NY |