Organization
ISLANDIA PHARMACY LTD
Active
Other names
ISLANDIA PHARMACY LTD
Organization subpart
No
Provider details
NPI number
Authorized official
MOMTAZ HASAN (PRESIDENT)
(516) 647-1582
Entity
Organization
Contact information
Practice address
333 S BROADWAY, HICKSVILLE, NY 11801-5005
(516) 939-9800
(516) 939-9801
Mailing address
333 S BROADWAY, HICKSVILLE, NY 11801-5005
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
028913
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3357868
OTHER ID NUMBER
—
Enumeration date
05/14/2008
Last updated
05/14/2008
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