Provider Demographics
NPI:1417608043
Name:NUCARE PHARMACY INC.
Entity Type:Organization
Organization Name:NUCARE PHARMACY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:RUSSELL
Authorized Official - Middle Name:
Authorized Official - Last Name:SHVARTSSHTEYN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-207-6310
Mailing Address - Street 1:1789 1ST AVE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10128-6901
Mailing Address - Country:US
Mailing Address - Phone:212-426-9300
Mailing Address - Fax:
Practice Address - Street 1:1789 1ST AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10128-6901
Practice Address - Country:US
Practice Address - Phone:212-426-9300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-14
Last Update Date:2022-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
No251F00000XAgenciesHome Infusion
No3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY33D2185044OtherLIMITED SERVICE LABORATORY REGISTRATION
NY029549OtherPHARMACY
NY03160881Medicaid