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General NPI Number Information
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NPI Number | 1720806680
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Entity Type | Organization
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Legal Business Name | 535 HICKSVILLE LLC
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Dates
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Enumeration Date | 09/30/2024
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Last Update Date | 01/29/2026
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Provider Practice Location Address
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Address Line | 535 S BROADWAY
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City | HICKSVILLE
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State | NY
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Zip | 11801-5029
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Country | US
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Telephone | 516-452-9991
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Fax | 516-452-9992
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Provider Business Mailing Address
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Address Line | 1785 DUTCH BROADWAY
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City | ELMONT
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State | NY
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Zip | 11003-5044
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Country | US
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Telephone | 516-872-8700
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Fax |
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Authorized Official
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Title or Position | PHARMACIST
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Name | MRS. ASRA KHAN
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Credential |
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Telephone | 516-452-9991
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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 |
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License Number State |
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