| NPI | 1215276142 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MADAN GUNTUPALLI Pharmacy Manager / Pharmacist 914-476-6060 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: NY 031871) |
| Enumeration Date | 2013-02-13 |
| Last Update Date | 2020-10-06 |