Organization
K.R.D.PHARMACY,INC.DBA SUNNYSIDE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID FISHBAIN (RPH)
(787) 729-1400
Entity
Organization
Contact information
Practice address
4811 SKILLMAN AVE, SUNNYSIDE, NY 11104-1025
(718) 729-1400
(718) 729-1406
Mailing address
4811 SKILLMAN AVE, SUNNYSIDE, NY 11104-1025
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
020254
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3395565
OTHER ID NUMBER
—
Enumeration date
04/25/2007
Last updated
06/17/2008
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