Provider Demographics
NPI:1144389966
Name:NEEL-PATH LLC
Entity Type:Organization
Organization Name:NEEL-PATH LLC
Other - Org Name:APALACHIN PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:JAYSUKH
Authorized Official - Middle Name:
Authorized Official - Last Name:LALKIYA
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:607-625-2129
Mailing Address - Street 1:PO BOX 376
Mailing Address - Street 2:
Mailing Address - City:APALACHIN
Mailing Address - State:NY
Mailing Address - Zip Code:13732-0376
Mailing Address - Country:US
Mailing Address - Phone:607-625-2129
Mailing Address - Fax:607-625-2428
Practice Address - Street 1:6845 STATE ROUTE 434
Practice Address - Street 2:
Practice Address - City:APALACHIN
Practice Address - State:NY
Practice Address - Zip Code:13732-3503
Practice Address - Country:US
Practice Address - Phone:607-625-2129
Practice Address - Fax:607-625-2428
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-07
Last Update Date:2012-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 3336C0004X
NY0235773336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No3336C0004XSuppliersPharmacyCompounding Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0014667700005Medicaid
NY01855921Medicaid
3344645OtherNCPDP PROVIDER IDENTIFICATION NUMBER
PA0014667700005Medicaid