Healthcare Provider Details

I. General information

NPI: 1891784195
Provider Name (Legal Business Name): ALL AMERICAN DRUGGIST INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/19/2005
Last Update Date: 09/19/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1101 BRIGHTON BEACH AVE
BROOKLYN NY
11235-5558
US

IV. Provider business mailing address

1101 BRIGHTON BEACH AVE
BROOKLYN NY
11235-5558
US

V. Phone/Fax

Practice location:
  • Phone: 718-891-2801
  • Fax: 718-743-5804
Mailing address:
  • Phone: 718-891-2801
  • Fax: 718-743-5804

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number018762
License Number StateNY

VIII. Authorized Official

Name: MARINA VAYSBAUM
Title or Position: SUP PHARM
Credential:
Phone: 718-891-2801