Provider Demographics
NPI:1568252864
Name:CROOKS AVENUE PHARMACY CORPORATION
Entity type:Organization
Organization Name:CROOKS AVENUE PHARMACY CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GHADA
Authorized Official - Middle Name:
Authorized Official - Last Name:ABUKUWAIK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-257-7765
Mailing Address - Street 1:311 CROOKS AVE
Mailing Address - Street 2:
Mailing Address - City:PATERSON
Mailing Address - State:NJ
Mailing Address - Zip Code:07503-1105
Mailing Address - Country:US
Mailing Address - Phone:862-225-9432
Mailing Address - Fax:
Practice Address - Street 1:311 CROOKS AVE
Practice Address - Street 2:
Practice Address - City:PATERSON
Practice Address - State:NJ
Practice Address - Zip Code:07503-1105
Practice Address - Country:US
Practice Address - Phone:862-225-9432
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-09
Last Update Date:2025-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy