| NPI | 1568403996 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN MURILLO Pharmacy Manager 212-639-2206 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy |
| Additional Taxonomies | 333600000X Pharmacy (Licence: NY 003945) |
| 3336I0012X Pharmacy Institutional Pharmacy | |
| 3336C0002X Pharmacy Clinic Pharmacy | |
| Enumeration Date | 2006-06-09 |
| Last Update Date | 2024-10-16 |