Organization
GRISTEDES FOODS INC
Active
Other names
Gristedes Pharmacy 560
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BARRY SHERMAN (VICE PRESIDENT)
(917) 217-2789
Entity
Organization
Contact information
Practice address
2109 BROADWAY, NEW YORK, NY 10023
(212) 787-4076
(212) 787-4083
Mailing address
2109 BROADWAY, NEW YORK, NY 10023
(212) 787-4076
(212) 787-4083
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
025551
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02380463
—
NY
01
—
3329201
NCPDP
—
Enumeration date
12/29/2005
Last updated
03/07/2023
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