MEDICARE: FRESH POND RX INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3336C0003X	Community/Retail Pharmacy

General Provider Information

NPI Number	:	1720557523
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FRESH POND RX INC

Provider Business Mailing Address
First Line	:	7104 FRESH POND RD
Second Line	:
City	:	RIDGEWOOD
State	:	NY
Zip	:	11385-5905
Country	:	US
Telephone Number	:	929-295-0033
Fax Number	:	929-295-0408

Provider Business Practice Location Address
First Line	:	7104 FRESH POND RD
Second Line	:
City	:	RIDGEWOOD
State	:	NY
Zip	:	11385-5905
Country	:	US
Telephone Number	:	929-295-0033
Fax Number	:	929-295-0408

Authorized Official
Title or Position	:	PRESIDENT
Name	:	PATRICK STUART OBRIEN
Credential	:
Telephone Number	:	929-295-0033

Provider Enumeration Date	:	11/21/2018
Last Update Date	:	03/04/2019

Similar Medicare Providers

1508860388 — DR. LEO MEIZLIK D.D.S.
Practice Location Address:

7106 FRESH POND RD
RIDGEWOOD, NY
11385-5905

Practice Phone: 718-821-9292
Practice Fax:

1942351879 — EYEBIZNET, INC.
Practice Location Address:

5905 71ST AVE
RIDGEWOOD, NY
11385-5655

Practice Phone: 718-386-8900
Practice Fax: 718-386-8400

1518890698 — MADISON RAE FARR PMHNP
Practice Location Address:

6686 FRESH POND RD
RIDGEWOOD, NY
11385-3949

Practice Phone: 718-576-3607
Practice Fax:

1396605135 — MRS. DANIELLE VALERIE ALBEOS TABEL-CASIO PT
Practice Location Address:

6421 FRESH POND RD
RIDGEWOOD, NY
11385-3330

Practice Phone: 631-209-5700
Practice Fax:

1336071810 — JAMES N MASCIALE
Practice Location Address:

6603 FRESH POND RD FL 1
RIDGEWOOD, NY
11385-3310

Practice Phone: 347-227-8334
Practice Fax:

1679192876 — KNICKERBOCKER DIALYSIS INC
Practice Location Address:

1734 HANCOCK ST
RIDGEWOOD, NY
11385-4734

Practice Phone: 929-290-1267
Practice Fax: 917-909-5950

Directions to “FRESH POND RX INC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.