Active NPI
Lydig Avenue Pharmacy Corp
- Pharmacy
- Bronx, NY
National Provider Identifier
1396750907
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacy
- License
- 026027
- Legal business name
- LYDIG AVENUE PHARMACY CORP
- Doing business as
- LYDIG AVENUE PHARMACY CORP
- Practice address
- 742 Lydig Ave
Bronx, NY 10462-2104 - Phone
- (718) 678-8700
- Fax
- (718) 678-8777
- NPI assigned
- Jul 30, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Muhammad Abid Javaid
- Title
- Pharmacist
- Phone
- (718) 678-8700
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | 026027 | NY | Primary |
| Community/Retail Pharmacy | 3336C0003X |
Addresses
Primary practice location
742 Lydig Ave
Bronx, NY 10462-2104
Mailing address
742 Lydig Ave
Bronx, NY 10462-2104
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3332688 | Other | OTHER ID NUMBER-COMMERCIAL NUMBER | |
| 02397304 | Medicaid | NY |
Other names 1
- LYDIG AVENUE PHARMACY CORP
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154217600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1313712000000",
"number": "1396750907",
"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"
},
{
"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": "2006-07-30",
"last_updated": "2011-08-19",
"status": "A",
"authorized_official_last_name": "JAVAID",
"authorized_official_first_name": "MUHAMMAD",
"authorized_official_middle_name": "ABID",
"authorized_official_title_or_position": "PHARMACIST",
"authorized_official_telephone_number": "718-678-8700"
},
"taxonomies": [
{
"code": "333600000X",
"taxonomy_group": "",
"desc": "Pharmacy",
"state": "NY",
"license": "026027",
"primary": true
},
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
"identifier": "3332688",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "02397304",
"state": "NY"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "LYDIG AVENUE PHARMACY CORP",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Bronx, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 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.