| NPI | 1821003476 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARAT BLUSTIN Owner/Sec 917-922-3204 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: NY 027708) |
| Enumeration Date | 2006-07-30 |
| Last Update Date | 2010-03-01 |