Organization
FSNR SNF LLC
Active
Other names
Four Seasons Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
JONATHAN SHAATAL RPH (DIRECTOR OF PHARMACY)
(718) 688-8755
Entity
Organization
Contact information
Practice address
1222 EAST 96TH STREET, BROOKLYN, NY 11236
(718) 688-8755
(718) 688-8774
Mailing address
1222 EAST 96TH STREET, BROOKLYN, NY 11236
(718) 688-8755
(718) 688-8774
Taxonomy
Speciality
Code
Description
License number
State
1835G0303X
Geriatric Pharmacist
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
027476
NY
3336L0003X
Long Term Care Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02829849
—
NY
05
—
05632944
—
NY
01
—
2067555
PK
—
Enumeration date
08/14/2006
Last updated
02/24/2022
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