| NPI | 1841034493 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK-NISSAN AKILOV Owner 718-480-6555 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2024-06-19 |
| Last Update Date | 2024-06-19 |