Organization
DEJON CORP
Active
Other names
ANSONIA CHEMIST
Organization subpart
No
Provider details
NPI number
Authorized official
DENNIS DESIMONE RPH (OWNER PHARMACIST)
(718) 965-0565
Entity
Organization
Contact information
Practice address
358 7TH AVE, BROOKLYN, NY 11215-4315
(718) 965-0565
(718) 965-4204
Mailing address
358 7TH AVE, BROOKLYN, NY 11215-4315
(718) 965-0565
(718) 965-4204
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
018365
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00861569
—
NY
01
—
2062199
PK
—
Enumeration date
07/30/2006
Last updated
07/21/2016
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