Healthcare Provider Details

I. General information

NPI: 1376940767
Provider Name (Legal Business Name): 7TH AVENUE PHARMACY INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/01/2014
Last Update Date: 05/16/2025
Certification Date: 05/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5412 7TH AVE
BROOKLYN NY
11220-3123
US

IV. Provider business mailing address

5412 7TH AVE
BROOKLYN NY
11220-3123
US

V. Phone/Fax

Practice location:
  • Phone: 718-633-2299
  • Fax: 718-633-2228
Mailing address:
  • Phone: 718-633-2299
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number033310
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: JANICE WU
Title or Position: CEO
Credential: RPH
Phone: 718-633-2299