Lydig Avenue Pharmacy Corp.

Primary specialty

PharmacyTaxonomy code 333600000X

Legal business name

LYDIG AVENUE PHARMACY CORP.

Practice address

742 Lydig Ave
Bronx, NY 10462-2104

Phone

(718) 678-8700

Fax

(718) 678-8777

NPI assigned

Mar 21, 2007

Organization subpart

No

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

Authorized official

Name

Mrs. Lyudmila Shalom, RPH

Title

Pharmacist

Phone

(718) 678-8700

Specialties & licenses 2

Addresses

Other identifiers 1

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

{
    "created_epoch": "1174435200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1192406400000",
    "number": "1225154339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "742 LYDIG AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104622104",
            "telephone_number": "718-678-8700",
            "fax_number": "718-678-8777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "742 LYDIG AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104622104",
            "telephone_number": "718-678-8700",
            "fax_number": "718-678-8777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LYDIG AVENUE PHARMACY CORP.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-21",
        "last_updated": "2007-10-15",
        "status": "A",
        "authorized_official_last_name": "SHALOM",
        "authorized_official_first_name": "LYUDMILA",
        "authorized_official_title_or_position": "PHARMACIST",
        "authorized_official_telephone_number": "718-678-8700",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NY",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02397304",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nadia Lyall
• Lindsey Lybrand, ATR-BC, LCAT
• Amy Beth Lyburn, LCSW
• Lydia Rabinowich MD PC
• Lydig Avenue Pharmacy Corp
• Lydig Dental
• Lydig Optical Lab
• Lydig Pediatrics PC
• Danette Nakita Lynch, OTR/L
• Jillian Lynch

• Pharmacy in Bronx, NY
• Providers in Bronx, NY by specialty
• Pharmacy in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2007; 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.