Provider Demographics
NPI:1568039998
Name:YORK AVENUE APOTHECARY LLC
Entity Type:Organization
Organization Name:YORK AVENUE APOTHECARY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERVISING PHARMACIST/OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:ILANA
Authorized Official - Middle Name:
Authorized Official - Last Name:AMINOV
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:917-957-9771
Mailing Address - Street 1:1631 YORK AVE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10028-6291
Mailing Address - Country:US
Mailing Address - Phone:212-737-8800
Mailing Address - Fax:212-628-0138
Practice Address - Street 1:1631 YORK AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10028-6291
Practice Address - Country:US
Practice Address - Phone:212-737-8800
Practice Address - Fax:212-628-0138
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-04
Last Update Date:2021-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy