Healthcare Provider Details

I. General information

NPI: 1376021188
Provider Name (Legal Business Name): BRIGHT ST. PHARMACY & MINI MARKET LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/02/2018
Last Update Date: 08/29/2025
Certification Date: 08/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2800 JOHN F KENNEDY BLVD
JERSEY CITY NJ
07306-5402
US

IV. Provider business mailing address

2800 JOHN F KENNEDY BLVD
JERSEY CITY NJ
07306-5402
US

V. Phone/Fax

Practice location:
  • Phone: 201-333-9900
  • Fax: 201-333-9004
Mailing address:
  • Phone: 201-333-9900
  • Fax: 201-333-9004

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number28RS00765800
License Number StateNJ

VIII. Authorized Official

Name: MISS AATIKA CHAUDHRY
Title or Position: OWNER
Credential:
Phone: 201-333-9900