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Organization
STATE OF NEW YORK COMPTROLLERS OFFICE
Active
Organization
STATE OF NEW YORK COMPTROLLERS OFFICE
Active
Other names
State University of New York Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY KOSTALOS (DIRECTOR OF REIMBURSEMENT)
(718) 826-4911
Entity
Organization
Contact information
Practice address
470A CLARKSON AVE, BROOKLYN, NY 11203-2012
(718) 270-7300
Mailing address
445 LENOX RD, BROOKLYN, NY 11203-2017
(718) 826-4911
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7001037
—
NY
Enumeration date
03/08/2021
Last updated
02/16/2022
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