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Organization

STARRETT CITY PHARMACY, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. IGOR VAYSBAUM RPH (PRESIDENT)
(718) 257-8777
Entity
Organization

Contact information

Practice address
1110 PENNSYLVANIA AVE, BROOKLYN, NY 11207-9061
(718) 257-8777
(718) 257-8884
Mailing address
1110 PENNSYLVANIA AVE, SUITE # 12, BROOKLYN, NY 11207-9061
(718) 257-8777
(718) 257-8884

Taxonomy

Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
025076
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02168005
NY
01
3322308
NCDP
NY
Enumeration date
10/19/2005
Last updated
08/22/2020
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