Organization
BRISELY PHARMACY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MANUEL ANTONIO MENDEZ PHARMACIST (SUPERVISING PHARMACIST)
(212) 781-6314
Entity
Organization
Contact information
Practice address
4229 BROADWAY, NEW YORK, NY 10033-3707
(212) 781-6314
(212) 795-7343
Mailing address
4229 BROADWAY, NEW YORK, NY 10033-3707
(212) 781-6314
(212) 795-7343
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
018799
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00914663
—
NY
01
—
3385158
PHARMACY
NY
Enumeration date
02/09/2007
Last updated
11/03/2008
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