Healthcare Provider Details

I. General information

NPI: 1407351190
Provider Name (Legal Business Name): KZ PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/26/2018
Last Update Date: 01/21/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5325 ROOSEVELT AVE
WOODSIDE NY
11377-4238
US

IV. Provider business mailing address

5325 ROOSEVELT AVE
WOODSIDE NY
11377-4238
US

V. Phone/Fax

Practice location:
  • Phone: 347-935-3224
  • Fax: 888-388-1606
Mailing address:
  • Phone: 347-935-3224
  • Fax: 888-388-1606

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number StateNY

VIII. Authorized Official

Name: IRINA HAKIMI
Title or Position: PRESIDENT
Credential:
Phone: 347-935-3224