Provider Demographics
NPI:1750780987
Name:ISABEL'S PHARMACY INC
Entity type:Organization
Organization Name:ISABEL'S PHARMACY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:IGOR
Authorized Official - Middle Name:
Authorized Official - Last Name:ALAYEV
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:718-655-4005
Mailing Address - Street 1:338 E GUN HILL RD
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10467-2208
Mailing Address - Country:US
Mailing Address - Phone:718-655-4005
Mailing Address - Fax:718-655-4011
Practice Address - Street 1:338 E GUN HILL RD
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10467-2208
Practice Address - Country:US
Practice Address - Phone:718-655-4005
Practice Address - Fax:718-655-4011
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-13
Last Update Date:2015-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY032942333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY032942OtherSTATE BOARD OF PHARMACY
NY7253550001Medicare NSC