Provider Demographics
NPI:1013489012
Name:RS GROUP NY CORP.
Entity Type:Organization
Organization Name:RS GROUP NY CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERVISING PHARMACIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ROMAN
Authorized Official - Middle Name:
Authorized Official - Last Name:FAZYLOV
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:646-519-0180
Mailing Address - Street 1:2452A EASTCHESTER RD
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10469-5916
Mailing Address - Country:US
Mailing Address - Phone:718-569-5040
Mailing Address - Fax:718-569-5041
Practice Address - Street 1:2452A EASTCHESTER RD
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10469-5916
Practice Address - Country:US
Practice Address - Phone:718-569-5040
Practice Address - Fax:718-569-5041
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-02
Last Update Date:2019-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy