Provider Demographics
NPI:1992879332
Name:DREAM PHARMACY AND SURGICAL SUPPLIES INC
Entity type:Organization
Organization Name:DREAM PHARMACY AND SURGICAL SUPPLIES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:ZAHRA
Authorized Official - Middle Name:NAJUM
Authorized Official - Last Name:HUSSAINI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-354-0131
Mailing Address - Street 1:61 EVANS ST
Mailing Address - Street 2:
Mailing Address - City:NEW HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11040-2062
Mailing Address - Country:US
Mailing Address - Phone:516-354-0131
Mailing Address - Fax:516-354-0131
Practice Address - Street 1:11204 101ST AVE
Practice Address - Street 2:
Practice Address - City:SOUTH RICHMOND HILL
Practice Address - State:NY
Practice Address - Zip Code:11419-1124
Practice Address - Country:US
Practice Address - Phone:718-441-3800
Practice Address - Fax:718-441-1086
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NEW LOTS PHARMACY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-11-18
Last Update Date:2014-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY025593183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02380707Medicaid
NY3330343OtherINSURANCES