Provider Demographics
NPI:1912424714
Name:WATTOO CORPORATION
Entity Type:Organization
Organization Name:WATTOO CORPORATION
Other - Org Name:HEALTHY WAYS PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROMANA
Authorized Official - Middle Name:
Authorized Official - Last Name:SHEIKH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-332-5263
Mailing Address - Street 1:3074 CONEY ISLAND AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-6319
Mailing Address - Country:US
Mailing Address - Phone:718-332-5263
Mailing Address - Fax:718-368-2710
Practice Address - Street 1:3074 CONEY ISLAND AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-6319
Practice Address - Country:US
Practice Address - Phone:718-332-5263
Practice Address - Fax:718-368-2710
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-23
Last Update Date:2021-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0354763336C0003X, 3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY035476OtherNY STATE BOARD OF PHARMACY
NY035476Medicaid