| NPI | 1710303128 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAULA GOLDSTEIN Division Administrator 646-962-2275 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332900000X Non-Pharmacy Dispensing Site (Licence: NY 135654-1) |
| Enumeration Date | 2014-03-10 |
| Last Update Date | 2014-03-10 |