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Organization
TISANE PHARMACY LLC
Active
Organization
TISANE PHARMACY LLC
Active
Other names
Tisane Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
INNA SHAFIR (OWNER)
(212) 517-0037
Entity
Organization
Contact information
Practice address
340 E 86TH ST, NEW YORK, NY 10028-4661
(212) 517-0037
(212) 517-0039
Mailing address
340 E 86TH ST, NEW YORK, NY 10028-4661
(212) 517-0037
(212) 517-0039
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
030789
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2131296
PK
—
Enumeration date
08/17/2011
Last updated
02/22/2016
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