Organization
2355 2ND AVE NYS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUE ROTURRA (COO)
(561) 323-8987
Entity
Organization
Contact information
Practice address
2355 2ND AVE, NEW YORK, NY 10035-3107
(212) 426-7151
Mailing address
2355 2ND AVE, NEW YORK, NY 10035-3107
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
06479881
—
NY
05
—
1057316H3S
—
NJ
Enumeration date
02/01/2023
Last updated
03/19/2025
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