Provider Demographics
NPI:1497143382
Name:CENTRAL PHARMACY OF BROOKLYN NY INC
Entity Type:Organization
Organization Name:CENTRAL PHARMACY OF BROOKLYN NY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:TATYANA
Authorized Official - Middle Name:
Authorized Official - Last Name:ELBERG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-646-2222
Mailing Address - Street 1:252 BRIGHTON BEACH AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-7427
Mailing Address - Country:US
Mailing Address - Phone:718-646-2222
Mailing Address - Fax:
Practice Address - Street 1:252 BRIGHTON BEACH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-7427
Practice Address - Country:US
Practice Address - Phone:718-646-2222
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-31
Last Update Date:2017-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY7470260001Medicare NSC