Provider Demographics
NPI:1295801009
Name:NEW PELHAM PARKWAY PHARMACY
Entity type:Organization
Organization Name:NEW PELHAM PARKWAY PHARMACY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:SHAHID
Authorized Official - Middle Name:Q
Authorized Official - Last Name:CHOHAN
Authorized Official - Suffix:
Authorized Official - Credentials:MS PHARMACY
Authorized Official - Phone:718-409-0908
Mailing Address - Street 1:2133 WILLIAMS BRIDGE ROAD
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10461
Mailing Address - Country:US
Mailing Address - Phone:718-409-0908
Mailing Address - Fax:718-822-3127
Practice Address - Street 1:2133 WILLIAMS BRIDGE ROAD
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461
Practice Address - Country:US
Practice Address - Phone:718-409-0908
Practice Address - Fax:718-822-3127
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-27
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01568941Medicaid
NY022512OtherNY LICENSE
BN4435764OtherDEA
NY01568941Medicaid
NY022512OtherNY LICENSE