| NPI | 1588191415 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OLEG LIVEYEV Owner 718-850-1100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: NY 035407) |
| Enumeration Date | 2017-05-23 |
| Last Update Date | 2022-07-21 |