Organization
BN PHARMACY INC
Active
Other names
NEW YORK BOULEVARD PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
BANANI DUTTA (PRESIDENT)
(718) 297-6500
Entity
Organization
Contact information
Practice address
107 45 NEW YORK BLVD, JAMAICA, NY 11433
(718) 297-6500
(718) 297-6501
Mailing address
107 45 NEW YORK BLVD, JAMAICA, NY 11433
(718) 297-6500
(718) 297-6501
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
019986
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01090633
—
NY
01
—
2065583
PK
—
Enumeration date
12/28/2006
Last updated
11/03/2014
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