Provider Demographics
NPI:1629526884
Name:NATES HUGUENOT PHARMACY CORP.
Entity Type:Organization
Organization Name:NATES HUGUENOT PHARMACY CORP.
Other - Org Name:NATES PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:BORIS
Authorized Official - Middle Name:
Authorized Official - Last Name:NATENZON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-734-4662
Mailing Address - Street 1:826 FOREST AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10310-2446
Mailing Address - Country:US
Mailing Address - Phone:718-720-3710
Mailing Address - Fax:
Practice Address - Street 1:877 HUGUENOT AVE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10312-3920
Practice Address - Country:US
Practice Address - Phone:718-509-4100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-16
Last Update Date:2016-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy