Provider Demographics
NPI:1205230547
Name:BRIGHTON PHARMACY II ,INC
Entity Type:Organization
Organization Name:BRIGHTON PHARMACY II ,INC
Other - Org Name:ZUCKERMAN DRUGS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:SANTOSH
Authorized Official - Middle Name:
Authorized Official - Last Name:KUMAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-743-1800
Mailing Address - Street 1:701 BRIGHTON BEACH AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-6413
Mailing Address - Country:US
Mailing Address - Phone:718-743-1800
Mailing Address - Fax:
Practice Address - Street 1:701 BRIGHTON BEACH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-6413
Practice Address - Country:US
Practice Address - Phone:718-743-1800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-15
Last Update Date:2015-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0332303336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY04130109Medicaid
NY7352290001OtherMEDICARE PTAN
NY7352290001OtherMEDICARE PTAN