MICHAEL WALLACE

STATEN ISLAND, NY
NPI1356917553
Former NameMICHAEL E WALLACE
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy183500000X Pharmacist
(Licence: NY  066034)
Enumeration Date2021-05-28
Last Update Date2021-05-28
Business Address
Mr. MICHAEL WALLACE
260 ARDEN AVE
STATEN ISLAND, NY 10312-1229
Phone number: 718-966-5509
Mailing Address
Mr. MICHAEL WALLACE
260 ARDEN AVE
STATEN ISLAND, NY 10312-1229
Phone number: 718-966-5509
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