Waldbaum INC

NPI #1558386102 in Setauket, New York

Provider Information

NPI Number: 1558386102
Entity Type: Organization
Organization Name: Waldbaum INC
Subpart: Yes (part of a larger organization)
Parent Organization: THE GREAT ATLANTIC AND PACIFIC TEA COMPANY INC
Primary Specialty: Pharmacy
Enumeration Date: Jul 13, 2006
Last Updated: Nov 15, 2007

Practice Location

Address: 4054 NESCONSET HWY
City: Setauket
State: New York
ZIP Code: 11733-3306
Phone: (631) 476-1586

Authorized Official

Name: SUSAN KIJOWSKI
Title: PHARMACY SPECIALIST
Phone: (201) 571-8326

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pharmacy - Community/Retail Pharmacy — Community/Retail Pharmacy	3336C0003X
Durable Medical Equipment & Medical Supplies	332B00000X
Pharmacy	333600000X	Primary

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