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

Pathmark Stores Inc

Organization Durable Medical Equipment & Medical Supplies · NPI 1962509737

Pathmark Stores Inc is a Durable Medical Equipment & Medical Supplies in Port Jefferson Station, New York. Licensed in New York. Registered with an NPI since 2006.

Licensed in
NY
In the registry since
2006
Specialties on file
3
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

5145 Nesconset Hwy
Port Jefferson Station, NY 11776-2047
Phone: (631) 331-2210
Fax: (631) 473-3291
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pharmacy (primary) Taxonomy 333600000X · Licence 016040 (NY)
Durable Medical Equipment & Medical Supplies Taxonomy 332B00000X · Licence 016040 (NY)
Community/Retail Pharmacy Taxonomy 3336C0003X

Record details

NPI number1962509737
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationGreat Atlantic & Pacific Tea Co , Inc, The
Authorized official Susan Kijowski — Manager, Regulatory Compliance · (201) 571-8326
Other names Pathmark Pharmacy
NPI enumeratedSeptember 20, 2006
Last updated in NPPESAugust 16, 2013
Mailing addressPo Box 416369, Boston, MA 02241-6369

Other providers in Port Jefferson Station