63rd Drive Pharmacy Corp
NPI #1023116050 in Rego Park, New York
Provider Information
- NPI Number
- 1023116050
- Entity Type
- Organization
- Organization Name
- 63rd Drive Pharmacy Corp
- Primary Specialty
- Pharmacy - Community/Retail Pharmacy
- Enumeration Date
- Sep 21, 2006
- Last Updated
- Sep 11, 2025
Practice Location
Authorized Official
- Name
- SIMON ILIZAROV
- Title
- PRESIDENT
- Phone
- (718) 459-3370
Specialties & Taxonomy Codes
| Specialty |
|---|
| Pharmacy |
| Pharmacy - Community/Retail Pharmacy — Community/Retail Pharmacy |
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