Provider Demographics
NPI:1508871120
Name:CARNEGIE PHARMACY INC
Entity Type:Organization
Organization Name:CARNEGIE PHARMACY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:SHYAM
Authorized Official - Middle Name:
Authorized Official - Last Name:MADOOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-987-9400
Mailing Address - Street 1:1842 2ND AVE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10128-3862
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1842 2ND AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10128-3862
Practice Address - Country:US
Practice Address - Phone:212-987-9400
Practice Address - Fax:212-987-6850
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-30
Last Update Date:2008-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0260933336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02412779Medicaid
3333200OtherOTHER ID NUMBER
3333200OtherOTHER ID NUMBER