Provider Demographics
NPI:1629785845
Name:ATJ ENTERPRISE INC.
Entity Type:Organization
Organization Name:ATJ ENTERPRISE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KOK TIMMY
Authorized Official - Middle Name:
Authorized Official - Last Name:LANG
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:347-893-4227
Mailing Address - Street 1:93 LYNHURST AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10305-1808
Mailing Address - Country:US
Mailing Address - Phone:347-893-4227
Mailing Address - Fax:
Practice Address - Street 1:1077 BAY ST STE 6
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10305-4918
Practice Address - Country:US
Practice Address - Phone:718-885-4260
Practice Address - Fax:845-648-3411
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-28
Last Update Date:2022-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY039876OtherSTATE BOARD OF PHARMACY