| NPI | 1679023915 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SO YOUNG PARK LEE Owner, PIC, AO 646-633-3950 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: NJ 28RS00751500) |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2016-10-11 |
| Last Update Date | 2017-03-01 |