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General NPI Number Information
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NPI Number | 1114915774
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Entity Type | Organization
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Legal Business Name | BRITTANY PHARMACY CORP.
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Dates
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Enumeration Date | 10/07/2005
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 395 AVENUE X
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City | BROOKLYN
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State | NY
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Zip | 11223-6004
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Country | US
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Telephone | 718-339-3131
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Fax | 718-339-9232
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Provider Business Mailing Address
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Address Line | 395 AVENUE X
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City | BROOKLYN
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State | NY
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Zip | 11223-6004
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Country | US
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Telephone | 718-339-3131
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Fax | 718-339-9232
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Authorized Official
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Title or Position | PHARMACIST/OWNER
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Name | MRS. LUBA BALYASNY
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Credential | RPH
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Telephone | 718-339-3131
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1835N1003X
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Taxonomy Name | Nutrition Support Pharmacist
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License Number | 025310
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 1835P1200X
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Taxonomy Name | Pharmacotherapy Pharmacist
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License Number | 025310
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 025310
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License Number State | NY
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