Provider Demographics
NPI:1760403729
Name:TURTLE BAY CHEMISTS
Entity Type:Organization
Organization Name:TURTLE BAY CHEMISTS
Other - Org Name:TURTLE BAY CHEMISTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:CORVI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-752-5151
Mailing Address - Street 1:901 2ND AVE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10017-1503
Mailing Address - Country:US
Mailing Address - Phone:212-752-5151
Mailing Address - Fax:212-308-1775
Practice Address - Street 1:901 2ND AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10017-1503
Practice Address - Country:US
Practice Address - Phone:212-752-5151
Practice Address - Fax:212-308-1775
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-22
Last Update Date:2017-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
NY0173403336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2063142OtherPK
NY02248093Medicaid