| NPI Details | |
|---|---|
| NPI | 1093960056 |
| Enumeration Date | 11/18/2008 |
| Last Updated | 07/06/2011 |
| Entity Type | Healthcare Provider |
| Active | Over 8 years ago |
| Authorized Information | |
|---|---|
| Name | STANISLAV STANISLAV |
| Position | PRESIDENT |
| Phone | (718) 996-7600 |
| Fax | (718) 996-7601 |
| Practice Location | |
|---|---|
| 3100 OCEAN PKWY BROOKLYN NY, 11235-8439, US |
|
| Phone | (718) 996-7600 |
| Fax | (718) 996-7601 |
| Business Location | |
|---|---|
| 3100 OCEAN PKWY BROOKLYN NY, 11235-8439, US |
|
| Phone | (718) 996-7600 |
| Fax | (718) 996-7601 |
| Toxanomy | |
|---|---|
| Taxonomy Code | 3336C0003X |
| License State | New York |
| License Number | 029236 |
| Remove 1093960056 NPI Number | |
According to our database, Boardwalk Rx Corp NPI is 1093960056, taxonomy code is 3336C0003X and license number is 029236, license state is located at New York. Boardwalk Rx Corp physically located at 3100 Ocean Pkwy, Brooklyn NY, 11235-8439. NPI Number 1033115704 has the healthcare provider type.
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1093960056 NPI number is provided on an as is basis without warranty of any kind. 1093960056 is maintained by the National Plan & Provider Enumeration System. The contents of Boardwalk Rx Corp are for informational purposes only.
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