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General NPI Number Information
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NPI Number | 1770637134
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Entity Type | Organization
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Legal Business Name | HEALTH MAX 5TH AVENUE INC.
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Dates
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Enumeration Date | 01/23/2007
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Last Update Date | 01/05/2024
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Provider Practice Location Address
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Address Line | 53-13 5TH AVE
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City | BROOKLYN
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State | NY
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Zip | 11220-3110
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Country | US
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Telephone | 718-567-8000
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Fax | 718-765-9056
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Provider Business Mailing Address
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Address Line | 53-13 5TH AVE
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City | BROOKLYN
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State | NY
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Zip | 11220-3110
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Country | US
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Telephone | 718-567-8000
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Fax | 718-765-9056
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Authorized Official
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Title or Position | OWNER
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Name | MICHAEL REZHETS
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Credential |
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Telephone | 718-567-8000
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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 | 025460
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License Number State | NY
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