Organization
STAR TREK PHCY INC
Active
Other names
STAR DRUG
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID KRELLENSTEIN (PRES)
(718) 295-4444
Entity
Organization
Contact information
Practice address
57 E KINGSBRIDGE RD, BRONX, NY 10468-7503
(718) 295-4444
(718) 367-9797
Mailing address
57 E KINGSBRIDGE RD, BRONX, NY 10468-7503
(718) 295-4444
(718) 367-9797
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
017224
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00634088
—
NY
01
—
3372389
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
08/04/2006
Last updated
11/23/2010
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