| NPI | 1093013930 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VINCENT WONG Supervising Pharmacist 718-567-3338 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: NY 030559) |
| Additional Taxonomies | 3336S0011X Pharmacy, Specialty Pharmacy (Licence: NY 030559) |
| Enumeration Date | 2011-03-02 |
| Last Update Date | 2014-04-28 |