Provider Demographics
NPI:1598839029
Name:UNZER PHARMACY INC
Entity Type:Organization
Organization Name:UNZER PHARMACY INC
Other - Org Name:UNZER PHARMACY INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRES
Authorized Official - Prefix:
Authorized Official - First Name:NORMAN
Authorized Official - Middle Name:
Authorized Official - Last Name:BLINDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-384-7334
Mailing Address - Street 1:572 BEDFORD AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11249-7608
Mailing Address - Country:US
Mailing Address - Phone:718-384-7334
Mailing Address - Fax:718-599-5155
Practice Address - Street 1:572 BEDFORD AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11249-7608
Practice Address - Country:US
Practice Address - Phone:718-384-7334
Practice Address - Fax:718-599-5155
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-17
Last Update Date:2014-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
NY0330333336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY267029Medicaid
2064311OtherPK