Provider Demographics
NPI:1700412186
Name:LENOX AVENUE NORTH CORP
Entity Type:Organization
Organization Name:LENOX AVENUE NORTH CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:OUMAR
Authorized Official - Middle Name:
Authorized Official - Last Name:TANGARA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-459-2518
Mailing Address - Street 1:543 LENOX AVE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10037-1806
Mailing Address - Country:US
Mailing Address - Phone:212-283-2136
Mailing Address - Fax:212-283-2463
Practice Address - Street 1:543 LENOX AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10037-1806
Practice Address - Country:US
Practice Address - Phone:212-283-2136
Practice Address - Fax:212-283-2463
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-18
Last Update Date:2020-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy