| NPI | 1801128525 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GHASSAN ABDELAZIZ Sp Pharmacist 718-765-0019 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: NY 030019) |
| Additional Taxonomies | 333600000X Pharmacy |
| 3336C0004X Pharmacy Compounding Pharmacy | |
| 3336L0003X Pharmacy Long Term Care Pharmacy | |
| Enumeration Date | 2010-02-05 |
| Last Update Date | 2018-07-19 |