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Organization
FSNR SNF LLC
Active
Organization
FSNR SNF LLC
Active
Other names
Four Seasons Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
JONATHAN SHAATAL RPH (DIRECTOR OF PHARMACY)
(718) 688-8755
Entity
Organization
Contact information
Practice address
1222 EAST 96TH STREET, BROOKLYN, NY 11236
(718) 688-8755
(718) 688-8774
Mailing address
1222 EAST 96TH STREET, BROOKLYN, NY 11236
(718) 688-8755
(718) 688-8774
Taxonomy
Speciality
Code
Description
License number
State
1835G0303X
Geriatric Pharmacist
—
NULL
1835G0303X
Geriatric Pharmacist
—
—
333600000X
Pharmacy
—
NULL
3336C0003X
Community/Retail Pharmacy
027476
NY
3336L0003X
Long Term Care Pharmacy
Primary
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02829849
—
NY
05
—
05632944
—
NY
01
—
2067555
PK
—
Enumeration date
08/14/2006
Last updated
02/24/2022
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