Provider Demographics
NPI:1356471023
Name:ARLO DRUG STORE OF LONG ISLAND INC
Entity Type:Organization
Organization Name:ARLO DRUG STORE OF LONG ISLAND INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:TODD
Authorized Official - Middle Name:
Authorized Official - Last Name:SVEC
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:516-798-9444
Mailing Address - Street 1:1022 PARK BLVD
Mailing Address - Street 2:
Mailing Address - City:MASSAPEQUA PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11762-2711
Mailing Address - Country:US
Mailing Address - Phone:516-798-9444
Mailing Address - Fax:516-798-0589
Practice Address - Street 1:1022 PARK BLVD
Practice Address - Street 2:
Practice Address - City:MASSAPEQUA PARK
Practice Address - State:NY
Practice Address - Zip Code:11762-2711
Practice Address - Country:US
Practice Address - Phone:516-798-9444
Practice Address - Fax:516-798-0589
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY038503183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00380570Medicaid