Provider Demographics
NPI:1972693414
Name:FEDERAL EASTERN CHEMISTS LLC
Entity Type:Organization
Organization Name:FEDERAL EASTERN CHEMISTS LLC
Other - Org Name:THERAPIE NY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SUPERVISING PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:KERIN
Authorized Official - Middle Name:
Authorized Official - Last Name:QUADERER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-877-3308
Mailing Address - Street 1:309 COLUMBUS AVE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10023-1910
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:309 COLUMBUS AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10023-1910
Practice Address - Country:US
Practice Address - Phone:212-877-3308
Practice Address - Fax:212-875-0255
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-13
Last Update Date:2008-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0279973336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02808937Medicaid
3341043OtherOTHER ID NUMBER-COMMERCIAL NUMBER
3341043OtherOTHER ID NUMBER
5810920001Medicare NSC