| NPI | 1710352836 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANNA ELISHAIYEV Supervising Pharmacist 718-935-1033 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: NY 034117) |
| Enumeration Date | 2015-12-01 |
| Last Update Date | 2019-04-17 |