Provider Demographics
NPI:1093232852
Name:NEIGHBORHOOD CHEMISTS CORP
Entity Type:Organization
Organization Name:NEIGHBORHOOD CHEMISTS CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ABA
Authorized Official - Middle Name:
Authorized Official - Last Name:YAKUBOV
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-997-1700
Mailing Address - Street 1:10017 QUEENS BLVD
Mailing Address - Street 2:
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-2452
Mailing Address - Country:US
Mailing Address - Phone:718-997-1700
Mailing Address - Fax:718-997-1701
Practice Address - Street 1:10017 QUEENS BLVD
Practice Address - Street 2:
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-2452
Practice Address - Country:US
Practice Address - Phone:718-997-1700
Practice Address - Fax:718-997-1701
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-23
Last Update Date:2023-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0356523336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY05183826Medicaid