Provider Demographics
NPI:1427414580
Name:BROTHER PHARMACY & SURGICALS INC
Entity Type:Organization
Organization Name:BROTHER PHARMACY & SURGICALS INC
Other - Org Name:CARE PHARMACY & SURGICALS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST IN CHARGE
Authorized Official - Prefix:MR
Authorized Official - First Name:RAM
Authorized Official - Middle Name:
Authorized Official - Last Name:NALAGORLA
Authorized Official - Suffix:
Authorized Official - Credentials:MS RPH
Authorized Official - Phone:212-281-2345
Mailing Address - Street 1:565 LENOX AVE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10037-1742
Mailing Address - Country:US
Mailing Address - Phone:212-281-2345
Mailing Address - Fax:212-281-6789
Practice Address - Street 1:565 LENOX AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10037-1742
Practice Address - Country:US
Practice Address - Phone:212-281-2345
Practice Address - Fax:212-281-6789
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-05
Last Update Date:2016-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0342483336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY7537810001Medicare NSC