Provider Demographics
NPI:1457930026
Name:BROOKLYN CHEM CORP
Entity Type:Organization
Organization Name:BROOKLYN CHEM CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GULYAMHUSEN
Authorized Official - Middle Name:
Authorized Official - Last Name:AZIMOV
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-456-5470
Mailing Address - Street 1:8820 ROOSEVELT AVE
Mailing Address - Street 2:
Mailing Address - City:JACKSON HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:11372-7966
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8820 ROOSEVELT AVE
Practice Address - Street 2:
Practice Address - City:JACKSON HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:11372-7966
Practice Address - Country:US
Practice Address - Phone:917-456-5470
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-02
Last Update Date:2021-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy