Provider Demographics
NPI:1205228327
Name:PRESCRIPTION PLUS AT WYKAGYL INC
Entity Type:Organization
Organization Name:PRESCRIPTION PLUS AT WYKAGYL INC
Other - Org Name:PRESCRIPTION PLUS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NAZISH
Authorized Official - Middle Name:
Authorized Official - Last Name:RAHMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:914-945-0000
Mailing Address - Street 1:105 CROTON AVE
Mailing Address - Street 2:
Mailing Address - City:OSSINING
Mailing Address - State:NY
Mailing Address - Zip Code:10562-4215
Mailing Address - Country:US
Mailing Address - Phone:914-945-0000
Mailing Address - Fax:914-945-7045
Practice Address - Street 1:105 CROTON AVE
Practice Address - Street 2:
Practice Address - City:OSSINING
Practice Address - State:NY
Practice Address - Zip Code:10562-4215
Practice Address - Country:US
Practice Address - Phone:914-945-0000
Practice Address - Fax:914-945-7045
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-26
Last Update Date:2015-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0331463336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2150497OtherPK