| NPI | 1679677132 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAJESH MATHEW Supervising Pharmacist / Manager 718-294-5588 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NY 15244) |
| Enumeration Date | 2006-09-12 |
| Last Update Date | 2020-10-02 |