Organization
CONEY ISLAND PHARMACY INC
Active
Other names
COMMUNITY CARE PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
LILY SIDDIQUI (PRESIDENT)
(718) 372-5300
Entity
Organization
Contact information
Practice address
2913 SURF AVE, BROOKLYN, NY 11224-1705
(718) 372-5300
(718) 372-2451
Mailing address
2913 SURF AVE, BROOKLYN, NY 11224-1705
(718) 372-5300
(718) 372-2451
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
023559
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02078191
—
NY
01
—
3340217
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
07/23/2006
Last updated
10/07/2010
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