Organization
M.M.J.J. INC.
Active
Other names
TERRACE APOTHECARY
Organization subpart
No
Provider details
NPI number
Authorized official
MARK C. GOLDSTEIN (PRESIDENT)
(631) 277-9515
Entity
Organization
Contact information
Practice address
64 CARLETON AVE STE B, ISLIP TERRACE, NY 11752-1500
(631) 277-9515
(631) 277-7844
Mailing address
64 CARLETON AVE STE B, ISLIP TERRACE, NY 11752-1500
(631) 277-9515
(631) 277-7844
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
017707
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00759866
—
NY
01
—
3376034
NCPDP
NY
Enumeration date
02/26/2007
Last updated
08/22/2020
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