Provider Demographics
NPI:1205675782
Name:ABIGAILS RX BOUTIQUE INC.
Entity type:Organization
Organization Name:ABIGAILS RX BOUTIQUE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ARTUR
Authorized Official - Middle Name:
Authorized Official - Last Name:NATANOV
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-676-2036
Mailing Address - Street 1:3121 OCEAN AVENUE UNIT 5
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-3405
Mailing Address - Country:US
Mailing Address - Phone:718-676-2036
Mailing Address - Fax:718-676-2037
Practice Address - Street 1:3121 OCEAN AVENUE UNIT 5
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-3405
Practice Address - Country:US
Practice Address - Phone:718-676-2036
Practice Address - Fax:718-332-5173
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-23
Last Update Date:2025-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy