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Organization

BROAD STREET PHARMA CORP

Active
Other names
broad street pharmacy
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JAMAL ALI (MANAGER)
(347) 464-1533
Entity
Organization

Contact information

Practice address
209 BROAD ST, STATEN ISLAND, NY 10304-2105
(347) 464-1533
Mailing address
209 BROAD ST, STATEN ISLAND, NY 10304-2105

Taxonomy

Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary

Other

Enumeration date
08/30/2022
Last updated
08/30/2022
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