Organization
STONY BROOK PHARMACY
Active
Other names
MEDICAL PARK DRUG AND SURGICAL
Organization subpart
No
Provider details
NPI number
Authorized official
MAX SALVATORE (OWNER)
(631) 751-4477
Entity
Organization
Contact information
Practice address
2500 NESCONSET HWY, STE 3 A, STONY BROOK, NY 11790-2555
(631) 751-4477
(631) 751-4962
Mailing address
2500 NESCONSET HWY, STE 3 A, STONY BROOK, NY 11790-2555
(631) 751-4477
(631) 751-4962
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
018464
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00890780
—
NY
01
—
2063472
PK
—
Enumeration date
06/30/2006
Last updated
10/28/2014
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