Organization
HEALTH BRIDGE INC
Active
Other names
PHARMACY EXPRESS
Organization subpart
No
Provider details
NPI number
Authorized official
MARIANA YUSUPOVA PHRMD (OWNER)
(718) 648-0002
Entity
Organization
Contact information
Practice address
274 BRIGHTON BEACH AVE, BROOKLYN, NY 11235-7411
(718) 648-0002
(718) 648-0700
Mailing address
274 BRIGHTON BEACH AVE, BROOKLYN, NY 11235-7411
(718) 648-0002
(718) 648-0700
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
027073
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02605521
—
NY
01
—
2063165
PK
—
Enumeration date
12/19/2005
Last updated
11/19/2013
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