Provider Demographics
NPI:1437569217
Name:NEW FAMILY PHARMACY LLC
Entity Type:Organization
Organization Name:NEW FAMILY PHARMACY LLC
Other - Org Name:FAMILY PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:KIRAN KUMAR RAJA
Authorized Official - Middle Name:
Authorized Official - Last Name:NAGARAJA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-281-4881
Mailing Address - Street 1:3 W 137TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10037-1900
Mailing Address - Country:US
Mailing Address - Phone:212-281-4881
Mailing Address - Fax:212-281-4882
Practice Address - Street 1:3 W 137TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10037-1900
Practice Address - Country:US
Practice Address - Phone:212-281-4881
Practice Address - Fax:212-281-4882
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-02
Last Update Date:2014-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY031858333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy