Healthcare Provider Details

I. General information

NPI: 1952230435
Provider Name (Legal Business Name): BLOSSOM AVE PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/19/2026
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13440 BLOSSOM AVE
FLUSHING NY
11355-3320
US

IV. Provider business mailing address

13440 BLOSSOM AVE
FLUSHING NY
11355-3320
US

V. Phone/Fax

Practice location:
  • Phone: 646-392-2001
  • Fax: 646-392-2002
Mailing address:
  • Phone: 646-392-2001
  • Fax: 646-392-2002

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State

VIII. Authorized Official

Name: BING CAI
Title or Position: OWNER
Credential:
Phone: 646-209-5528