Healthcare Provider Details

I. General information

NPI: 1457362006
Provider Name (Legal Business Name): KEW GARDENS PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/10/2006
Last Update Date: 09/19/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8157 LEFFERTS BLVD
KEW GARDENS NY
11415-1728
US

IV. Provider business mailing address

8157 LEFFERTS BLVD
KEW GARDENS NY
11415-1728
US

V. Phone/Fax

Practice location:
  • Phone: 718-850-5220
  • Fax: 718-850-5220
Mailing address:
  • Phone: 718-850-5220
  • Fax: 718-850-5220

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 Number023105
License Number StateNY

VIII. Authorized Official

Name: GEORGE BLIKSTEIN
Title or Position: VP
Credential:
Phone: 718-850-5220