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NPI Code Detail

MEDICARE: SUCCESSFUL PHARMACY INC

MEDICARE: SUCCESSFUL PHARMACY 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
1333600000XPharmacy
23336C0003XCommunity/Retail Pharmacy031307NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
12135532OTHERPK

General Provider Information

NPI Number : 1760743959
Entity Type Code : Organization
Provider Name (Legal Business Name) : SUCCESSFUL PHARMACY INC
Provider Business Mailing Address
First Line : 1301 AVENUE U
Second Line :
City : BROOKLYN
State : NY
Zip : 11229-3305
Country : US
Telephone Number : 718-676-1516
Fax Number : 718-676-1517
Provider Business Practice Location Address
First Line : 1301 AVENUE U
Second Line :
City : BROOKLYN
State : NY
Zip : 11229-3305
Country : US
Telephone Number : 718-676-1516
Fax Number : 718-676-1517
Authorized Official
Title or Position : OWNER
Name : JANE NADELSON
Credential :
Telephone Number : 718-934-0090
Provider Enumeration Date : 06/04/2012
Last Update Date : 09/19/2025

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Directions to “SUCCESSFUL PHARMACY INC ” Practice Location

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