Provider Demographics
NPI:1275930612
Name:HABITAT PHARMACY, INC.
Entity Type:Organization
Organization Name:HABITAT PHARMACY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:MS
Authorized Official - First Name:SHERIN
Authorized Official - Middle Name:
Authorized Official - Last Name:AYOUB
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:917-613-2593
Mailing Address - Street 1:525 3RD AVE
Mailing Address - Street 2:PHARMACY
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-4168
Mailing Address - Country:US
Mailing Address - Phone:212-685-8600
Mailing Address - Fax:212-685-1700
Practice Address - Street 1:525 3RD AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-4168
Practice Address - Country:US
Practice Address - Phone:212-685-8600
Practice Address - Fax:212-685-1700
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-01
Last Update Date:2014-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0332353336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy