Organization
SIDDIQUI CORPORATION
Active
Other names
The Medicine Shoppe Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
PERVEZ SIDDIQUI (PRESIDENT)
(718) 434-4649
Entity
Organization
Contact information
Practice address
1109 CONEY ISLAND AVE, BROOKLYN, NY 11230-2305
(718) 434-4649
(718) 434-4168
Mailing address
1109 CONEY ISLAND AVE, BROOKLYN, NY 11230-2305
(718) 434-4649
(718) 434-4168
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
033394
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2151104
PK
—
Enumeration date
03/23/2015
Last updated
07/05/2016
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