Provider Demographics
NPI:1316196983
Name:PROMISA PHARMACY INC.
Entity Type:Organization
Organization Name:PROMISA PHARMACY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:QAISER
Authorized Official - Middle Name:MEHMOOD
Authorized Official - Last Name:CHAUDHARY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-294-1049
Mailing Address - Street 1:280-288 EAST 174TH ST.
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10457
Mailing Address - Country:US
Mailing Address - Phone:718-294-1049
Mailing Address - Fax:718-294-1054
Practice Address - Street 1:284 E 174TH ST.
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10457
Practice Address - Country:US
Practice Address - Phone:718-294-1049
Practice Address - Fax:718-294-1054
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-18
Last Update Date:2008-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0290543336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy