Provider Demographics
NPI:1780822445
Name:NUCARE PHARMACY INC.
Entity Type:Organization
Organization Name:NUCARE PHARMACY INC.
Other - Org Name:NUCARE PHARMACY & SURGICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RUSSELL
Authorized Official - Middle Name:
Authorized Official - Last Name:SHVARTSSHTEYN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-207-6310
Mailing Address - Street 1:1789 1ST AVE.
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10128
Mailing Address - Country:US
Mailing Address - Phone:718-997-8200
Mailing Address - Fax:718-997-8080
Practice Address - Street 1:1789 1ST AVE.
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10128
Practice Address - Country:US
Practice Address - Phone:718-997-8200
Practice Address - Fax:718-997-8080
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-03
Last Update Date:2022-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No291U00000XLaboratoriesClinical Medical Laboratory
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY029549OtherPHARMACY LIC#
NY03160881Medicaid
NY33D2185044OtherLIMITED SERVICE LABORATORY REGISTRATION