Organization · Type 2 NPI

Waldbaum Inc

Pharmacy · Staten Island, NY

NPI number 1093730640 Active

Practice location

1441 Richmond Ave
Staten Island, NY 10314-1553

Fax (718) 698-1945

Specialties and licenses

Taxonomy	Code	License
Durable Medical Equipment & Medical Supplies	332B00000X	023768 (NY)
Pharmacy Primary	333600000X	023768 (NY)
Community/Retail Pharmacy	3336C0003X	None listed

Pharmacy: 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 lo…

2 other providers at this address

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NPI record

NPI: 1093730640
Entity type: Organization (Type 2)
Issued: Jul 13, 2006
Last updated: Nov 9, 2007
Status: Active
Subpart: Yes of The Great Atlantic and Pacific Tea Company Inc

Other names

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Waldbaums Pharmacy · doing business as

Authorized official

Susan Kijowski
Pharmacy Specialist
(201) 571-8326

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1093730640

Waldbaum Inc's National Provider Identifier is 1093730640, issued on Jul 13, 2006. The primary taxonomy on file is Pharmacy (333600000X), and the practice location is in Staten Island, NY. The record was last updated on Nov 9, 2007.