Organization
SAI SIVA PHARMACY LLC
Active
Other names
Kings Park Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
RAJASEKHAR KANTAMNENI (MANAING MEMBER)
(631) 663-3800
Entity
Organization
Contact information
Practice address
64 INDIAN HEAD RD, KINGS PARK, NY 11754-3703
(631) 663-3800
(631) 663-3799
Mailing address
64 INDIAN HEAD RD, KINGS PARK, NY 11754-3703
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Enumeration date
03/31/2020
Last updated
07/29/2025
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