Custom Chemists Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

030608 Issued in NY

Legal business name

CUSTOM CHEMISTS PHARMACY INC

Practice address

127 Spruce St Unit a
Cedarhurst, NY 11516-1923

Phone

(516) 341-0500

Fax

(516) 341-0501

NPI assigned

Jul 22, 2011

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Daniel Zinkovsky, PHARMD

Title

Supervising Pharmacist

Phone

(516) 341-0500

Specialties & licenses 2

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1311292800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1311292800000",
    "number": "1114205333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "127 SPRUCE ST UNIT A",
            "city": "CEDARHURST",
            "state": "NY",
            "postal_code": "115161923",
            "telephone_number": "516-341-0500",
            "fax_number": "516-341-0501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "127 SPRUCE ST UNIT A",
            "city": "CEDARHURST",
            "state": "NY",
            "postal_code": "115161923",
            "telephone_number": "516-341-0500",
            "fax_number": "516-341-0501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CUSTOM CHEMISTS PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-22",
        "last_updated": "2011-07-22",
        "status": "A",
        "authorized_official_last_name": "ZINKOVSKY",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_title_or_position": "SUPERVISING PHARMACIST",
        "authorized_official_telephone_number": "516-341-0500",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NY",
            "license": "030608",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": "NY",
            "license": "030608",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bryan Jonathan Cordero, AGNP
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• Gabriella Daniel
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• Richard Davidson, DDS

• Community/Retail Pharmacy in Cedarhurst, NY
• Providers in Cedarhurst, NY by specialty
• Community/Retail Pharmacy in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.