Healthcare Provider Details

I. General information

NPI: 1134068133
Provider Name (Legal Business Name): ALDAV PHARMACY, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/25/2026
Last Update Date: 03/25/2026
Certification Date: 03/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

749 OCEAN PKWY
BROOKLYN NY
11230-7813
US

IV. Provider business mailing address

749 OCEAN PKWY
BROOKLYN NY
11230-7813
US

V. Phone/Fax

Practice location:
  • Phone: 718-724-2245
  • Fax: 718-724-0975
Mailing address:
  • Phone: 718-724-2245
  • Fax: 718-724-0975

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State

VIII. Authorized Official

Name: RENA YANVARASHVILI
Title or Position: SUPERVISING PHARMACIST
Credential:
Phone: 718-724-2245