| NPI | 1518555994 |
|---|---|
| Doing Business As | 14TH ST PHARMACY |
| Entity Type | Organization |
| Authorized Contact | NIKOLAY KAZAKOV President 718-550-4668 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Enumeration Date | 2021-01-01 |
| Last Update Date | 2022-02-01 |