Healthcare Provider Details

I. General information

NPI: 1144219734
Provider Name (Legal Business Name): RED HOOK PHARMACY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/17/2005
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

376 VAN BRUNT ST
BROOKLYN NY
11231-1235
US

IV. Provider business mailing address

376 VAN BRUNT ST
BROOKLYN NY
11231-1235
US

V. Phone/Fax

Practice location:
  • Phone: 718-797-0200
  • Fax: 718-797-5090
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number026309
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: BERNARD GLEZERMAN
Title or Position: SUP PHARM
Credential: RPH
Phone: 718-797-0200