| NPI | 1033342605 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MAHUA RAHMAN Supervising Pharmacist 718-239-3500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: NY 029593) |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2009-08-31 |
| Last Update Date | 2018-07-19 |