Organization
SANDLANE PHARMACY CORP.
Active
Other names
Nates pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
BORIS NATENZON RPH (PRES)
(718) 556-3330
Entity
Organization
Contact information
Practice address
307 SAND LN, STATEN ISLAND, NY 10305-4500
(718) 556-3330
Mailing address
516 BROADWAY, STATEN ISLAND, NY 10310-2446
(718) 556-3330
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
025486
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02317917
—
NY
Enumeration date
05/23/2007
Last updated
02/02/2011
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