Organization
CASTLETON PHARMACY CORP
Active
Other names
Enexia Specialty
Organization subpart
No
Provider details
NPI number
Authorized official
BORIS NATENZON (PRESIDENT)
(718) 720-3710
Entity
Organization
Contact information
Practice address
252 PORT RICHMOND AVE, STATEN ISLAND, NY 10302-1749
(718) 556-0942
(718) 720-5612
Mailing address
826 FOREST AVE, STATEN ISLAND, NY 10310-2446
(718) 720-3710
(718) 360-9650
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
029846
NY
3336C0004X
Compounding Pharmacy
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
029846
—
NY
01
—
2119258
PK
—
Enumeration date
03/06/2009
Last updated
04/10/2017
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