| NPI | 1275787509 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAVI PANCHAL Supervising Pharmacist 718-486-0344 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: NY 029152) |
| Additional Taxonomies | 3336C0004X Pharmacy Compounding Pharmacy |
| 333600000X Pharmacy | |
| Enumeration Date | 2008-11-13 |
| Last Update Date | 2016-10-03 |