Healthcare Provider Details

I. General information

NPI: 1275458127
Provider Name (Legal Business Name): SUMMIT PHARMACY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/11/2026
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

356 E 8TH ST
NEW YORK NY
10009-5396
US

IV. Provider business mailing address

356 E 8TH ST
NEW YORK NY
10009-5396
US

V. Phone/Fax

Practice location:
  • Phone: 917-677-9605
  • Fax: 631-498-7001
Mailing address:
  • Phone: 917-677-9605
  • Fax: 631-498-7001

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: ALESIA KHAFIZOVA
Title or Position: MEMBER
Credential: PHARMD
Phone: 347-809-1705