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Organization
63RD RX CORP.
Active
Organization
63RD RX CORP.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL KAKZANOV (PRESIDENT)
(718) 897-4747
Entity
Organization
Contact information
Practice address
9855 63RD RD, REGO PARK, NY 11374-1739
(718) 897-4747
(718) 897-4748
Mailing address
9855 63RD RD, REGO PARK, NY 11374-1739
(718) 897-4747
(718) 897-4748
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
NULL
333600000X
Pharmacy
Primary
—
NULL
Other
Enumeration date
03/30/2022
Last updated
10/23/2023
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