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General NPI Number Information
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NPI Number | 1063596294
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Entity Type | Organization
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Legal Business Name | HARRICO KNICKERBOCKER DRUG CORP
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Dates
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Enumeration Date | 10/24/2006
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 214 STANHOPE ST
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City | BROOKLYN
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State | NY
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Zip | 11237-4202
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Country | US
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Telephone | 718-452-5521
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Fax | 718-452-2368
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Provider Business Mailing Address
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Address Line | 214 STANHOPE ST
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City | BROOKLYN
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State | NY
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Zip | 11237-4202
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Country | US
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Telephone | 718-452-5521
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Fax | 718-773-5568
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Authorized Official
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Title or Position | SUPERVISING PHARMACIST/OWNER
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Name | MRS. SHAMA NOOR
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Credential | R.PH.
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Telephone | 718-452-5521
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 1952
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License Number State | NY
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