Healthcare Provider Details

I. General information

NPI: 1104745017
Provider Name (Legal Business Name): TERESA RX INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/14/2026
Last Update Date: 07/14/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

582 ROCKAWAY AVE
BROOKLYN NY
11212-5625
US

IV. Provider business mailing address

582 ROCKAWAY AVE
BROOKLYN NY
11212-5625
US

V. Phone/Fax

Practice location:
  • Phone: 718-342-3446
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: SANDIP PATEL
Title or Position: PRESIDENT
Credential:
Phone: 718-342-3446