Provider Demographics
NPI:1194164608
Name:CENTRAL PHARMACY OF BROOKLYN LTD
Entity type:Organization
Organization Name:CENTRAL PHARMACY OF BROOKLYN LTD
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRERSIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LIYA
Authorized Official - Middle Name:
Authorized Official - Last Name:LEVINSKY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-451-9022
Mailing Address - Street 1:252 BRIGHTON BEACH AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-7427
Mailing Address - Country:US
Mailing Address - Phone:718-646-2222
Mailing Address - Fax:718-646-2225
Practice Address - Street 1:252 BRIGHTON BEACH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-7427
Practice Address - Country:US
Practice Address - Phone:718-646-2222
Practice Address - Fax:718-646-2225
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-18
Last Update Date:2014-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0321593336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03607009Medicaid
2142028OtherPK