| NPI | 1184917163 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TATYANA LEVIK Owner 917-951-7833 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: NY 030803) |
| Additional Taxonomies | 3336C0004X Pharmacy Compounding Pharmacy |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| 3336M0003X Pharmacy Managed Care Organization Pharmacy | |
| 333600000X Pharmacy | |
| Enumeration Date | 2011-05-24 |
| Last Update Date | 2016-04-01 |