Organization
DREZEN'S PHARMACY INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JONG DAE LEE (PRESIDENT)
(718) 652-1363
Entity
Organization
Contact information
Practice address
774 ALLERTON AVE, BRONX, NY 10467-8910
(718) 652-1363
(718) 652-0849
Mailing address
774 ALLERTON AVE, BRONX, NY 10467-8910
(718) 652-1363
(718) 652-0849
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
017343
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00679823
—
NY
01
—
017343
NYS PHARMACY LICENSE NO.
NY
Enumeration date
07/29/2006
Last updated
11/11/2008
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