Organization
NATES SPECIALTY PHARMACY CORP
Active
Other names
Nates Specialty Pharmacy and Surgical Supplies
Organization subpart
No
Provider details
NPI number
Authorized official
BORIS NATENZON (PRESIDENT)
(917) 734-4662
Entity
Organization
Contact information
Practice address
2304 NOSTRAND AVE, BROOKLYN, NY 11210-3840
(718) 338-0709
(718) 338-3880
Mailing address
516 BROADWAY, STATEN ISLAND, NY 10310-2804
(718) 720-3710
(718) 360-9650
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
—
—
3336C0004X
Compounding Pharmacy
Primary
030093
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03250222
—
NY
01
—
5800215
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
05/20/2010
Last updated
10/17/2011
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