Provider Demographics
NPI:1013148543
Name:HUDSON SQUARE PHARMACY
Entity Type:Organization
Organization Name:HUDSON SQUARE PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RPH
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:V
Authorized Official - Last Name:CANNIZZARO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-989-1400
Mailing Address - Street 1:345 HUDSON ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10014-4502
Mailing Address - Country:US
Mailing Address - Phone:212-989-1400
Mailing Address - Fax:212-989-1403
Practice Address - Street 1:345 HUDSON ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10014-4502
Practice Address - Country:US
Practice Address - Phone:212-989-1400
Practice Address - Fax:212-989-1403
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-31
Last Update Date:2009-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY031526183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty