| NPI | 1679044648 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEANA S KANDOV Member 718-685-2129 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Additional Taxonomies | 291U00000X Clinical Medical Laboratory |
| 305S00000X Point of Service | |
| 405300000X Prevention Professional | |
| Enumeration Date | 2018-12-16 |
| Last Update Date | 2023-02-10 |