Organization
ST GABRIEL PHARMACY CORP
Active
Other names
St Gabriel Pharmacy Corp.
Organization subpart
No
Provider details
NPI number
Authorized official
DANERIS JIMENEZ (PRESIDENT)
(718) 294-3770
Entity
Organization
Contact information
Practice address
20-22 W BURNSIDE AVE, BRONX, NY 10453-4004
(718) 294-3770
(718) 294-3772
Mailing address
20-22 W BURNSIDE AVE, BRONX, NY 10453-4004
(718) 294-3770
(718) 294-3772
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
028000
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02824633
—
NY
01
—
2068666
PK
—
Enumeration date
11/01/2006
Last updated
10/29/2025
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