Provider Demographics
NPI:1023151420
Name:MAIORINO PHARMACY & SURGICAL INC
Entity type:Organization
Organization Name:MAIORINO PHARMACY & SURGICAL INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:
Authorized Official - Last Name:CATANESE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:631-585-7092
Mailing Address - Street 1:233 UNION AVE
Mailing Address - Street 2:
Mailing Address - City:HOLBROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11741-1820
Mailing Address - Country:US
Mailing Address - Phone:631-585-7092
Mailing Address - Fax:631-585-8059
Practice Address - Street 1:233 UNION AVE
Practice Address - Street 2:
Practice Address - City:HOLBROOK
Practice Address - State:NY
Practice Address - Zip Code:11741-1820
Practice Address - Country:US
Practice Address - Phone:631-585-7092
Practice Address - Fax:631-585-8059
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-15
Last Update Date:2016-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
NY0167663336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00891007Medicaid
2060110OtherPK
NY00891007Medicaid