Provider Demographics
NPI:1174985485
Name:NEW YORK METHODIST APOTHECARY
Entity type:Organization
Organization Name:NEW YORK METHODIST APOTHECARY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OF PHARMACY
Authorized Official - Prefix:MR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:
Authorized Official - Last Name:BALMIR
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:718-780-5575
Mailing Address - Street 1:501 6TH ST
Mailing Address - Street 2:DEPARTMENT OF PHARMACY
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11215-3671
Mailing Address - Country:US
Mailing Address - Phone:718-780-5575
Mailing Address - Fax:
Practice Address - Street 1:506 6TH ST
Practice Address - Street 2:NEW YORK METHODIST APOTHECARY
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11215-3609
Practice Address - Country:US
Practice Address - Phone:718-780-5575
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NEW YORK METHODIST HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-03-25
Last Update Date:2016-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY490107010016415183700000X
NY040428183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty
No183700000XPharmacy Service ProvidersPharmacy TechnicianGroup - Single Specialty