| NPI | 1891784195 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARINA VAYSBAUM Sup Pharm 718-891-2801 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: NY 018762) |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2005-10-19 |
| Last Update Date | 2018-07-19 |