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General NPI Number Information
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NPI Number | 1992658264
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Entity Type | Organization
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Legal Business Name | BAYSIDE FAMILY PHARMACY INC.
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Dates
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Enumeration Date | 02/17/2026
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Last Update Date | 02/17/2026
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Provider Practice Location Address
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Address Line | 20836 CROSS ISLAND PKWY FL 2
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City | BAYSIDE
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State | NY
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Zip | 11360-1187
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Country | US
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Telephone | 347-408-4035
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Fax |
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Provider Business Mailing Address
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Address Line | 280 E CHESTER ST
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City | VALLEY STREAM
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State | NY
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Zip | 11580-4710
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | SUPERVISING PHARMACIST
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Name | MICHAEL BABAKHANOV
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Credential |
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Telephone | 347-653-3674
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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