| NPI | 1558726182 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEVEN TUCKMAN Manager 718-920-5194 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy |
| Additional Taxonomies | 3336C0002X Pharmacy Clinic Pharmacy (Licence: NY TBD) |
| 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: NY TBD) | |
| Enumeration Date | 2015-12-28 |
| Last Update Date | 2015-12-28 |