Provider Demographics
NPI:1528076635
Name:METRO-NORTH PHARMACY INC.
Entity type:Organization
Organization Name:METRO-NORTH PHARMACY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRES.
Authorized Official - Prefix:
Authorized Official - First Name:SHAHIDA
Authorized Official - Middle Name:NASREEN
Authorized Official - Last Name:QADIR
Authorized Official - Suffix:
Authorized Official - Credentials:BS
Authorized Official - Phone:212-427-1718
Mailing Address - Street 1:16 FLAG HILL RD
Mailing Address - Street 2:
Mailing Address - City:CHAPPAQUA
Mailing Address - State:NY
Mailing Address - Zip Code:10514-3032
Mailing Address - Country:US
Mailing Address - Phone:914-747-6845
Mailing Address - Fax:212-427-1190
Practice Address - Street 1:1972 1ST AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029-6430
Practice Address - Country:US
Practice Address - Phone:914-747-6845
Practice Address - Fax:212-427-1190
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY024291332BP3500X, 3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
Not Answered3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01928472Medicaid
NY01928472Medicaid