Organization
LUNA PARK PHARMACY INC
Active
Other names
LUNA PARK PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
MIKHAIL FAZYLOV (OWNER)
(718) 974-9611
Entity
Organization
Contact information
Practice address
2875 W 8TH ST, BROOKLYN, NY 11224-3601
(718) 946-5444
(718) 946-5355
Mailing address
2875 W 8TH ST, BROOKLYN, NY 11224-3601
(718) 946-5444
(718) 946-5355
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
023200
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01788678
—
NY
01
—
2062588
PK
—
Enumeration date
09/30/2006
Last updated
10/27/2025
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