Organization
LENOX TERRACE PHARMACY INC
Active
Other names
LENOX TERRACE DRUG STORE INC
Organization subpart
No
Provider details
NPI number
Authorized official
BRAHMAJI VALIVETZ (PRESIDENT)
(212) 234-2050
Entity
Organization
Contact information
Practice address
20 W 135TH ST, NEW YORK, NY 10037-2534
(212) 234-2050
(212) 234-3970
Mailing address
20 W 135TH ST, NEW YORK, NY 10037-2534
(212) 234-2050
(212) 234-3970
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
025372
NY
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02238728
—
NY
01
—
2067030
PK
—
Enumeration date
07/30/2006
Last updated
08/31/2016
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