Provider Demographics
NPI:1194265819
Name:BYER, IRVING
Entity type:Individual
Prefix:MR
First Name:IRVING
Middle Name:
Last Name:BYER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:47 W 74TH ST
Mailing Address - Street 2:2B
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10023-2492
Mailing Address - Country:US
Mailing Address - Phone:212-873-1375
Mailing Address - Fax:
Practice Address - Street 1:255 COLUMBUS AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10023-3330
Practice Address - Country:US
Practice Address - Phone:212-362-9170
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-28
Last Update Date:2017-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY026444183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist