Provider Demographics
NPI:1225184435
Name:ISAK PHARMACY INC.
Entity Type:Organization
Organization Name:ISAK PHARMACY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:GHEYAS
Authorized Official - Middle Name:A
Authorized Official - Last Name:IQBAL
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMACY
Authorized Official - Phone:718-465-8739
Mailing Address - Street 1:19507 JAMAICA AVE
Mailing Address - Street 2:
Mailing Address - City:HOLLIS
Mailing Address - State:NY
Mailing Address - Zip Code:11423-2639
Mailing Address - Country:US
Mailing Address - Phone:718-465-8739
Mailing Address - Fax:718-776-5902
Practice Address - Street 1:19507 JAMAICA AVE
Practice Address - Street 2:
Practice Address - City:HOLLIS
Practice Address - State:NY
Practice Address - Zip Code:11423-2639
Practice Address - Country:US
Practice Address - Phone:718-465-8739
Practice Address - Fax:718-776-5902
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-28
Last Update Date:2011-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY018250183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty