Provider Demographics
NPI:1053863431
Name:LAFAYETTE FAMILY PHARMACY INC
Entity Type:Organization
Organization Name:LAFAYETTE FAMILY PHARMACY INC
Other - Org Name:LAFAYETTE FAMILY PHARMACY INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ABDULRAB
Authorized Official - Middle Name:
Authorized Official - Last Name:ALSAYEDI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-618-7205
Mailing Address - Street 1:849 SOUNDVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10473-3903
Mailing Address - Country:US
Mailing Address - Phone:718-618-7205
Mailing Address - Fax:718-618-7204
Practice Address - Street 1:849 SOUNDVIEW AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10473-3903
Practice Address - Country:US
Practice Address - Phone:718-618-7205
Practice Address - Fax:718-618-7204
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-01
Last Update Date:2019-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
NY0348253336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2166195OtherPK