Provider Demographics
NPI:1700077641
Name:ASTORIA FAMILY PHARMACY, INC.
Entity Type:Organization
Organization Name:ASTORIA FAMILY PHARMACY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/ SUPERVISING PHARMACIST
Authorized Official - Prefix:DR
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:
Authorized Official - Last Name:ZOOBI
Authorized Official - Suffix:
Authorized Official - Credentials:PHARM D
Authorized Official - Phone:917-582-2885
Mailing Address - Street 1:2590 STEINWAY ST
Mailing Address - Street 2:
Mailing Address - City:ASTORIA
Mailing Address - State:NY
Mailing Address - Zip Code:11103-3703
Mailing Address - Country:US
Mailing Address - Phone:718-777-1155
Mailing Address - Fax:718-777-1158
Practice Address - Street 1:2590 STEINWAY ST
Practice Address - Street 2:
Practice Address - City:ASTORIA
Practice Address - State:NY
Practice Address - Zip Code:11103-3703
Practice Address - Country:US
Practice Address - Phone:718-777-1155
Practice Address - Fax:718-777-1158
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-06
Last Update Date:2008-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0284653336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
5986880001Medicare NSC