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General NPI Number Information
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NPI Number | 1275673923
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Entity Type | Organization
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Legal Business Name | LIFE PHARMACY INC
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Dates
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Enumeration Date | 02/08/2007
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Last Update Date | 06/05/2025
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Provider Practice Location Address
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Address Line | 4301 14TH AVE
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City | BROOKLYN
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State | NY
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Zip | 11219-1429
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Country | US
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Telephone | 718-438-1421
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Fax | 718-438-1483
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Provider Business Mailing Address
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Address Line | 4301 14TH AVE
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City | BROOKLYN
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State | NY
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Zip | 11219-1429
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Country | US
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Telephone | 718-438-1421
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Fax | 718-438-1483
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Authorized Official
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Title or Position | PHARMACIST
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Name | ELAN GUTMAN
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Credential |
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Telephone | 718-438-1421
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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 | 047043-1
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License Number State | NY
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