Provider Demographics
NPI:1497737753
Name:APTEKA CORP
Entity Type:Organization
Organization Name:APTEKA CORP
Other - Org Name:ABC PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:MARYANA
Authorized Official - Middle Name:
Authorized Official - Last Name:ROZENBAUM
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:718-853-7766
Mailing Address - Street 1:371 MCDONALD AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11218-2211
Mailing Address - Country:US
Mailing Address - Phone:718-853-7766
Mailing Address - Fax:718-853-7007
Practice Address - Street 1:371 MCDONALD AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11218-2211
Practice Address - Country:US
Practice Address - Phone:718-853-7766
Practice Address - Fax:718-853-7007
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-14
Last Update Date:2022-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY026014183500000X, 332B00000X
333600000X, 3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Single Specialty
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY3332272OtherNCPDP
NY02393108Medicaid
4800360001Medicare NSC
NY02393108Medicaid