| NPI | 1275043200 |
|---|---|
| Doing Business As | STATEN ISLAND PHARMACY |
| Entity Type | Organization |
| Authorized Contact | GENE MAZEPA President 718-489-4994 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy |
| Enumeration Date | 2017-10-04 |
| Last Update Date | 2017-10-04 |