| NPI | 1578544839 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARTIN BENNETT Supervising Pharmacist 718-681-5644 |
| Organization Subpart ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NY 21343) |
| Enumeration Date | 2005-11-11 |
| Last Update Date | 2010-01-28 |