Healthcare Provider Details

I. General information

NPI: 1316446784
Provider Name (Legal Business Name): DYKER CHEMIST
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/12/2018
Last Update Date: 05/30/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7313 13TH AVE
BROOKLYN NY
11228
US

IV. Provider business mailing address

7313 13TH AVE
BROOKLYN NY
11228-2026
US

V. Phone/Fax

Practice location:
  • Phone: 718-232-0013
  • Fax:
Mailing address:
  • Phone: 718-232-0013
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number036056
License Number StateNY

VIII. Authorized Official

Name: SHERIF ATEF
Title or Position: PARTNER/VICE PRESIDENT
Credential:
Phone: 347-761-6416