Healthcare Provider Details

I. General information

NPI: 1962569574
Provider Name (Legal Business Name): DKY ENTERPRISES INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/02/2007
Last Update Date: 09/27/2024
Certification Date: 09/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5504 8TH AVE
BROOKLYN NY
11220-3516
US

IV. Provider business mailing address

5504 8TH AVE
BROOKLYN NY
11220-3516
US

V. Phone/Fax

Practice location:
  • Phone: 718-438-3838
  • Fax: 718-438-8756
Mailing address:
  • Phone: 718-438-3838
  • Fax: 718-438-8756

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code1835G0303X
TaxonomyGeriatric Pharmacist
License Number
License Number StateNULL

VIII. Authorized Official

Name: TIMMY LANG
Title or Position: PRESIDENT
Credential: PHARMD
Phone: 718-438-3838