| NPI | 1609167196 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | YELENA KUZNETSOVA Supervising Pharmacist 718-646-0001 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy (Licence: NY 030569) |
| Enumeration Date | 2011-05-02 |
| Last Update Date | 2011-05-02 |