Organization
MODERN PHARMACY INCORPORATED
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHAGATA NATH (PRESIDENT/ SUPERVISING PHARMACIST)
(917) 258-1753
Entity
Organization
Contact information
Practice address
9502 VAN WYCK EXPY, SOUTH RICHMOND HILL, NY 11419-1638
(888) 585-6874
(917) 764-8038
Mailing address
9502 VAN WYCK EXPY, SOUTH RICHMOND HILL, NY 11419-1638
(888) 585-6874
(917) 764-8038
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
039465
NEW YORK STATE EDUCATION DEPARTMENT BOARD OFFICE FOR PHARMACY & MIDWIFERY
NY
Enumeration date
04/13/2022
Last updated
02/28/2023
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