# GREIS PARK SHOP INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** greis park pharmacy
- **Organization subpart:** No

## Provider details

- **NPI number:** 1952195703
- **Authorized official:** MR. MICHAEL BORUKHOV (OWNER)
- **Authorized official phone:** (917) 584-4030

## Contact information

- **Practice address:** 602 MERRICK RD, LYNBROOK, NY 11563-2306
- **Practice address phone:** (516) 998-0011
- **Mailing address:** 602 MERRICK RD, LYNBROOK, NY 11563-2306
- **Mailing address phone:** (516) 998-0011

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | — |
| 333600000X | Pharmacy | — | NULL | Yes |
| 3336C0003X | Community/Retail Pharmacy | — | NULL | — |

## Other

- **Enumeration date:** 04/07/2025
- **Last updated:** 08/04/2025