| NPI | 1770297772 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREW FYNE Pharmacy Manager 718-710-8432 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy |
| Additional Taxonomies | 291U00000X Clinical Medical Laboratory |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| 333600000X Pharmacy | |
| Enumeration Date | 2023-01-13 |
| Last Update Date | 2025-04-27 |