Organization
DE WITT REHAB AND NURSING HOME PHCY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EDWARD AHRENS R.PH (SUPERVISING PHARMACIST)
(212) 879-1600
Entity
Organization
Contact information
Practice address
211 E 79TH ST, NEW YORK, NY 10021-0819
(212) 879-1600
(212) 879-4594
Mailing address
211 E 79TH ST, NEW YORK, NY 10021-0819
(212) 879-1600
(212) 879-4594
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
025580
NY
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00310421
—
NY
01
—
3337979
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
06/24/2006
Last updated
12/16/2008
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