Organization
NICHOLAS AVE PHARMACY INC
Active
Other names
BELLOS PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
PRAMOD TANNA (OWNER)
(718) 456-1795
Entity
Organization
Contact information
Practice address
179 SAINT NICHOLAS AVE, BROOKLYN, NY 11237-4441
(718) 456-1795
(718) 628-6741
Mailing address
179 SAINT NICHOLAS AVE, BROOKLYN, NY 11237-4441
(718) 456-1795
(718) 456-1795
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
021646
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01393851
—
NY
01
—
2059781
PK
—
Enumeration date
06/23/2006
Last updated
04/05/2017
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