Provider Demographics
NPI:1669837316
Name:CRESCENT PHARMACY INC
Entity Type:Organization
Organization Name:CRESCENT PHARMACY INC
Other - Org Name:NY PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KIRAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SALKAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-777-2266
Mailing Address - Street 1:2914 CRESCENT ST
Mailing Address - Street 2:
Mailing Address - City:ASTORIA
Mailing Address - State:NY
Mailing Address - Zip Code:11102-3140
Mailing Address - Country:US
Mailing Address - Phone:718-777-2266
Mailing Address - Fax:718-777-2275
Practice Address - Street 1:2914 CRESCENT ST
Practice Address - Street 2:
Practice Address - City:ASTORIA
Practice Address - State:NY
Practice Address - Zip Code:11102-3140
Practice Address - Country:US
Practice Address - Phone:718-777-2266
Practice Address - Fax:718-777-2275
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-23
Last Update Date:2016-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY034316333600000X
3336S0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336S0011XSuppliersPharmacySpecialty Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2156177OtherPK
NY7516020001Medicare NSC