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General NPI Number Information
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NPI Number | 1073950663
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Entity Type | Organization
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Legal Business Name | EAST NY PHARMACY INC.
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Dates
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Enumeration Date | 05/23/2013
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Last Update Date | 05/23/2013
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Provider Practice Location Address
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Address Line | 1611 E NEW YORK AVE PHARMACY DEPARTMENT
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City | BROOKLYN
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State | NY
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Zip | 11212-6860
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Country | US
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Telephone | 347-331-0522
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Fax | 347-331-0544
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Provider Business Mailing Address
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Address Line | 1611 E NEW YORK AVE
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City | BROOKLYN
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State | NY
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Zip | 11212-6860
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Country | US
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Telephone | 347-331-0522
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Fax | 347-331-0544
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Authorized Official
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Title or Position | SUPERVISING PHARMACIST
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Name | MR. MARK RABBANI
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Credential | RPH
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Telephone | 347-313-0522
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | 031583
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License Number State | NY
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