Provider Demographics
NPI:1780047308
Name:CATALPA CHEMISTS CORP
Entity type:Organization
Organization Name:CATALPA CHEMISTS CORP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:GAVRIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:NORMATOV
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-366-3871
Mailing Address - Street 1:5701 CATALPA AVE
Mailing Address - Street 2:
Mailing Address - City:RIDGEWOOD
Mailing Address - State:NY
Mailing Address - Zip Code:11385-4902
Mailing Address - Country:US
Mailing Address - Phone:718-366-3871
Mailing Address - Fax:718-366-3905
Practice Address - Street 1:5701 CATALPA AVE
Practice Address - Street 2:
Practice Address - City:RIDGEWOOD
Practice Address - State:NY
Practice Address - Zip Code:11385-4902
Practice Address - Country:US
Practice Address - Phone:718-366-3871
Practice Address - Fax:718-366-3905
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-31
Last Update Date:2016-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 333600000X
NY0344383336C0003X, 3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2159346OtherPK