Provider Demographics
NPI:1336931781
Name:CONGERS RX LLC
Entity type:Organization
Organization Name:CONGERS RX LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:FNU
Authorized Official - Middle Name:
Authorized Official - Last Name:MASOOD SHAREEF ARIF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:845-848-1900
Mailing Address - Street 1:44 LAKE RD STE 101
Mailing Address - Street 2:
Mailing Address - City:CONGERS
Mailing Address - State:NY
Mailing Address - Zip Code:10920-2351
Mailing Address - Country:US
Mailing Address - Phone:845-848-1900
Mailing Address - Fax:
Practice Address - Street 1:44 LAKE RD STE 101
Practice Address - Street 2:
Practice Address - City:CONGERS
Practice Address - State:NY
Practice Address - Zip Code:10920-2351
Practice Address - Country:US
Practice Address - Phone:845-848-1900
Practice Address - Fax:845-848-1166
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-21
Last Update Date:2025-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY041796OtherLICENSE