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Organization
STONY BROOK PHARMACY
Active
Organization
STONY BROOK PHARMACY
Active
Other names
MEDICAL PARK DRUG AND SURGICAL
Organization subpart
No
Provider details
NPI number
Authorized official
MAX SALVATORE (OWNER)
(631) 751-4477
Entity
Organization
Contact information
Practice address
2500 NESCONSET HWY, STE 3 A, STONY BROOK, NY 11790-2555
(631) 751-4477
(631) 751-4962
Mailing address
2500 NESCONSET HWY, STE 3 A, STONY BROOK, NY 11790-2555
(631) 751-4477
(631) 751-4962
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
018464
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00890780
—
NY
01
—
2063472
PK
—
Enumeration date
06/30/2006
Last updated
10/28/2014
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