| NPI | 1427533231 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IGOR ILYAZAROV President 718-544-3200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2018-09-27 |
| Last Update Date | 2018-09-27 |