Organization
LYDIG AVENUE PHARMACY CORP.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LYUDMILA SHALOM RPH (PHARMACIST)
(718) 678-8700
Entity
Organization
Contact information
Practice address
742 LYDIG AVE, BRONX, NY 10462-2104
(718) 678-8700
(718) 678-8777
Mailing address
742 LYDIG AVE, BRONX, NY 10462-2104
(718) 678-8700
(718) 678-8777
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
—
—
3336C0003X
Community/Retail Pharmacy
—
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02397304
—
NY
Enumeration date
03/21/2007
Last updated
10/15/2007
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