| NPI | 1598739260 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LARISA KAPUSTINA Supervisino Pharmacist 718-627-7070 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy (Licence: NY 025834) |
| Enumeration Date | 2006-02-17 |
| Last Update Date | 2008-11-19 |