Petar R Banovic
Individual provider Active NPI Pharmacist · Larchmont, NY
NPI 1285501460 · NPPES record last updated Oct 21, 2025
Key facts
- NPI
- 1285501460
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 073087 (NY)
- Practice address
- 2141 Palmer Ave
Larchmont, NY 10538-2406 - Phone
- (914) 341-1900
- NPI assigned
- Oct 21, 2025
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 073087 | NY | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Larchmont Pharmacy LLC | Current |
Accepting new patients | |
| Matland Pharmacy Corp | Past | Accepting new patients |
Locations
2141 Palmer Ave
Larchmont, NY 10538
Phone (914) 341-1900
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 073087 | NY | Yes |
Addresses
Primary practice location
2141 Palmer Ave
Larchmont, NY 10538-2406
Mailing address
1447 159TH St
Whitestone, NY 11357-2720
Phone (914) 708-9618
Other practice location 1
1142 Lexington Ave
New York, NY 10075-0307
Phone (212) 744-4144
Other providers in Larchmont, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 21, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.