2355 2ND Ave Nys LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

2355 2ND AVE NYS LLC

Doing business as

Quick RX

Practice address

2355 2ND Ave
New York, NY 10035-3107

Phone

(212) 426-7151

Fax

(646) 290-6472

NPI assigned

Jan 25, 2007

Organization subpart

No

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

Authorized official

Name

Sue Rottura

Title

Coo

Phone

(561) 323-8987

Specialties & licenses 3

Addresses

Other identifiers 3

Other names 1

• QUICK RX Doing business as

Medicare fee-for-service enrollment

Enrolled in NY2 enrollments

Enrollment records 2

Tax ID family

2355 2ND Ave Corp2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• 2355 2ND Ave Nys LLC

  • Long Term Care Pharmacy
  • New York, NY
  • NPI 1679279756
  NPD tax ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Larisa Shalonov, RPH

  • Pharmacist
  • New York, NY
  • NPI 1649451238
  NPD

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

{
    "created_epoch": "1169683200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695686400000",
    "number": "1679628747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2355 2ND AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100353107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2355 2ND AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100353107",
            "telephone_number": "212-426-7151",
            "fax_number": "646-290-6472"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "2355 2ND AVE NYS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-25",
        "last_updated": "2023-09-26",
        "certification_date": "2023-09-26",
        "status": "A",
        "authorized_official_last_name": "ROTTURA",
        "authorized_official_first_name": "SUE",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "561-323-8987"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "038283",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2858726",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2068954",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "QUICK RX",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in New York, NY
• Providers in New York, 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 Sep 26, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.