Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Broad Street Pharma Corp

Organization Community/Retail Pharmacy · NPI 1396465407

Broad Street Pharma Corp is a Community/Retail Pharmacy in Staten Island, New York. Registered with an NPI since 2022.

In the registry since
2022
What do these letters mean?
Corp — Corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

209 Broad St
Staten Island, NY 10304-2105
Phone: (347) 464-1533
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Community/Retail Pharmacy (primary) Taxonomy 3336C0003X

Record details

NPI number1396465407
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jamal Ali — Manager · (347) 464-1533
Other names Broad Street Pharmacy
NPI enumeratedAugust 30, 2022
Last updated in NPPESAugust 30, 2022
Certification dateAugust 30, 2022
Mailing address209 Broad St, Staten Island, NY 10304-2105

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