Provider Demographics
NPI:1063803401
Name:NEW CITY RX LLC
Entity type:Organization
Organization Name:NEW CITY RX LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ZIA
Authorized Official - Middle Name:ULLAH
Authorized Official - Last Name:KHAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:845-425-1131
Mailing Address - Street 1:200 E ECKERSON RD STE 170
Mailing Address - Street 2:
Mailing Address - City:NEW CITY
Mailing Address - State:NY
Mailing Address - Zip Code:10956-7166
Mailing Address - Country:US
Mailing Address - Phone:845-425-1131
Mailing Address - Fax:914-425-8035
Practice Address - Street 1:200 E ECKERSON RD STE 170
Practice Address - Street 2:
Practice Address - City:NEW CITY
Practice Address - State:NY
Practice Address - Zip Code:10956-7164
Practice Address - Country:US
Practice Address - Phone:845-425-1131
Practice Address - Fax:914-425-8035
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-06
Last Update Date:2025-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
NY0335933336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2153570OtherPK
NY04213741Medicaid