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Organization

LIBERTY AVE PHARMACY,INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. ABU S AZAM RPH. (SP)
(718) 827-7528
Entity
Organization

Contact information

Practice address
1108 LIBERTY AVE, BROOKLYN, NY 11208-2922
(718) 827-7528
(718) 277-0193
Mailing address
1108 LIBERTY AVE, BROOKLYN, NY 11208-2922
(718) 827-7528
(718) 277-0193

Taxonomy

Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
024286
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01900921
NY
Enumeration date
02/24/2007
Last updated
08/22/2020
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