| NPI | 1063940443 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALISHO FATTAHOV President 718-393-2300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: NY 035409) |
| Enumeration Date | 2017-05-30 |
| Last Update Date | 2020-06-03 |