Provider Demographics
NPI:1508619115
Name:KIRYAS JOEL PHARMACY INC
Entity Type:Organization
Organization Name:KIRYAS JOEL PHARMACY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:KAHAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:845-783-3399
Mailing Address - Street 1:51 FOREST RD STE 211
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:NY
Mailing Address - Zip Code:10950-2936
Mailing Address - Country:US
Mailing Address - Phone:845-783-3399
Mailing Address - Fax:
Practice Address - Street 1:51 FOREST RD STE 211
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:NY
Practice Address - Zip Code:10950-2936
Practice Address - Country:US
Practice Address - Phone:845-783-3399
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-11
Last Update Date:2024-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy