Organization
CREST PHARMACY LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMNER MAVLYANOV (PRESIDENT)
(718) 399-8677
Entity
Organization
Contact information
Practice address
913 FULTON ST, BROOKLYN, NY 11238-1752
(718) 399-8677
(718) 399-8684
Mailing address
913 FULTON ST, BROOKLYN, NY 11238-1752
(718) 399-8677
(718) 399-8684
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
024379
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01916756
—
NY
Enumeration date
10/09/2006
Last updated
04/06/2026
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