Provider Demographics
NPI:1518369263
Name:KNICKERBOCKER CHEMISTS INC.
Entity Type:Organization
Organization Name:KNICKERBOCKER CHEMISTS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:SAL
Authorized Official - Middle Name:
Authorized Official - Last Name:HALABI
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:718-483-9102
Mailing Address - Street 1:360 KNICKERBOCKER AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11237-8053
Mailing Address - Country:US
Mailing Address - Phone:718-483-9102
Mailing Address - Fax:718-483-9104
Practice Address - Street 1:360 KNICKERBOCKER AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11237-8053
Practice Address - Country:US
Practice Address - Phone:718-483-9102
Practice Address - Fax:718-483-9104
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-24
Last Update Date:2018-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY032750332B00000X, 3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies