Provider Demographics
NPI:1770736027
Name:PARVJAYRON CORP
Entity type:Organization
Organization Name:PARVJAYRON CORP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SP, PIC
Authorized Official - Prefix:
Authorized Official - First Name:KEYUR
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-795-3033
Mailing Address - Street 1:1341 SAINT NICHOLAS AVE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10033-7236
Mailing Address - Country:US
Mailing Address - Phone:212-795-3033
Mailing Address - Fax:212-795-3036
Practice Address - Street 1:1341 SAINT NICHOLAS AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10033-7236
Practice Address - Country:US
Practice Address - Phone:212-795-3033
Practice Address - Fax:212-795-3036
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-30
Last Update Date:2014-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
NY0291483336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2118121OtherPK
NY03035178Medicaid
6163520001Medicare NSC