Healthcare Provider Details

I. General information

NPI: 1932231768
Provider Name (Legal Business Name): BRONX COMMUNITY PHARMACY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/09/2007
Last Update Date: 02/11/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2404 WEBSTER AVE
BRONX NY
10458-5603
US

IV. Provider business mailing address

2404 WEBSTER AVE
BRONX NY
10458-5603
US

V. Phone/Fax

Practice location:
  • Phone: 718-220-1336
  • Fax: 718-220-1338
Mailing address:
  • Phone: 718-220-1336
  • Fax: 718-220-1338

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number028188
License Number StateNY

VIII. Authorized Official

Name: NADEEM AKHTAR
Title or Position: PRESIDENT
Credential:
Phone: 201-310-2221