MEDICARE: SHOREVIEW SPECIALTY INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	333600000X	Pharmacy
2	3336C0004X	Compounding Pharmacy
3	3336C0003X	Community/Retail Pharmacy	033723	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2151880	OTHER		PK
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1598142259
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SHOREVIEW SPECIALTY INC

Provider Business Mailing Address
First Line	:	1853 CROPSEY AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11214-6035
Country	:	US
Telephone Number	:	718-265-4646
Fax Number	:	718-265-1406

Provider Business Practice Location Address
First Line	:	1853 CROPSEY AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11214-6035
Country	:	US
Telephone Number	:	718-265-4646
Fax Number	:	718-265-1406

Authorized Official
Title or Position	:	MANAGER
Name	:	FASIAL SULEHRI
Credential	:
Telephone Number	:	718-265-4646

Provider Enumeration Date	:	05/01/2015
Last Update Date	:	04/21/2021

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Directions to “SHOREVIEW SPECIALTY INC ” Practice Location

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