Organization
GREEN LEAF PHARMACY INC
Active
Other names
SURF AVENUE PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
VERANIKA SPETALIUN (PRESIDENT)
(718) 266-6111
Entity
Organization
Contact information
Practice address
2115 SURF AVE, BROOKLYN, NY 11224-2108
(718) 266-6111
(718) 266-2000
Mailing address
2115 SURF AVE, BROOKLYN, NY 11224-2108
(718) 266-6111
(718) 266-2000
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
036029
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2174329
PK
—
Enumeration date
11/30/2017
Last updated
09/19/2025
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