| NPI | 1013515873 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BORIS ISKHAKOV Owner 718-393-5590 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336S0011X Pharmacy, Specialty Pharmacy |
| Additional Taxonomies | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Enumeration Date | 2020-10-14 |
| Last Update Date | 2023-11-28 |