Provider Demographics
NPI:1013057553
Name:BATTERY PARK PHARMACY INC
Entity Type:Organization
Organization Name:BATTERY PARK PHARMACY INC
Other - Org Name:BATTERY PARK PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:KWACK
Authorized Official - Suffix:
Authorized Official - Credentials:BACHELOR
Authorized Official - Phone:212-912-0556
Mailing Address - Street 1:327 S END AVE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10280-1002
Mailing Address - Country:US
Mailing Address - Phone:212-912-0555
Mailing Address - Fax:212-912-0617
Practice Address - Street 1:327 S END AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10280-1002
Practice Address - Country:US
Practice Address - Phone:212-912-0555
Practice Address - Fax:212-912-0617
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-07
Last Update Date:2016-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
NY0178983336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01595459Medicaid
2061889OtherPK