Provider Demographics
NPI:1700245693
Name:SPECIALTY INFUSIONS INC.
Entity Type:Organization
Organization Name:SPECIALTY INFUSIONS INC.
Other - Org Name:PRIME INFUSIONS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SUPERVISING PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:WESTLEIGH
Authorized Official - Middle Name:
Authorized Official - Last Name:NIRENBERG
Authorized Official - Suffix:
Authorized Official - Credentials:PHARM D
Authorized Official - Phone:718-443-4000
Mailing Address - Street 1:1624 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11207-1026
Mailing Address - Country:US
Mailing Address - Phone:718-443-4000
Mailing Address - Fax:718-443-5000
Practice Address - Street 1:1624 BROADWAY
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11207-1026
Practice Address - Country:US
Practice Address - Phone:718-443-4000
Practice Address - Fax:718-443-5000
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-19
Last Update Date:2019-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251F00000X, 332B00000X
NY034107333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No251F00000XAgenciesHome Infusion
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies