Organization
ALDERTON PHARMACY LLC
Active
Other names
ALDERTON PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
OLEG SHLIPERMAN (MEMBER)
(646) 734-5835
Entity
Organization
Contact information
Practice address
9110 63RD DR, REGO PARK, NY 11374-3850
(718) 896-8500
(718) 896-8508
Mailing address
9833 64TH AVE, REGO PARK, NY 11374-2544
(718) 896-8500
(718) 896-8508
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
030923
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5803588
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
09/30/2011
Last updated
09/18/2012
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