LYDIG AVENUE PHARMACY CORP. NPI 1225154339

NPI Information

  • NPI: 1225154339
  • Provider Name: LYDIG AVENUE PHARMACY CORP.
  • Classification: Pharmacy - 333600000X
  • Entity Type: Organization
  • Address: 742 LYDIG AVE
    BRONX, NY
    ZIP 10462
  • Phone: (718) 678-8700

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NPI Details

LYDIG AVENUE PHARMACY CORP. is a pharmacy in Bronx, NY. The provider is a facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located. LYDIG AVENUE PHARMACY CORP. NPI is 1225154339. The provider is registered as an organization entity type.

The provider's business location address is:

742 LYDIG AVE
BRONX, NY
ZIP 10462-104
Phone: (718) 678-8700
Fax: (718) 678-8777

The provider's authorized official is Lyudmila Shalom .
The authorized official title is Pharmacist and has the following contact phone number (718) 678-8700.

The enumeration date for this NPI number is 3/21/2007 and was last updated on 10/15/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
13336C0003XPharmacyCommunity/Retail PharmacyNEW YORKNo
2333600000XPharmacyYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
14823230001MEDICARE ID-TYPE UNSPECIFIEDNEW YORKPROVIDER #
202397304MEDICAIDNEW YORK

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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