Healthcare Provider Details

I. General information

NPI: 1053774570
Provider Name (Legal Business Name): LENLAK INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/01/2016
Last Update Date: 09/19/2025
Certification Date: 10/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

325 NEW DORP LN
STATEN ISLAND NY
10306-3005
US

IV. Provider business mailing address

325 NEW DORP LN
STATEN ISLAND NY
10306-3005
US

V. Phone/Fax

Practice location:
  • Phone: 718-351-2400
  • Fax: 718-351-5400
Mailing address:
  • Phone: 718-351-2400
  • Fax: 718-351-5400

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: OLENA KURUS
Title or Position: PRESIDENT
Credential: PHARMD
Phone: 718-351-2400