| NPI | 1902206956 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ILYA ILYAYEV President 718-576-6556 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: NY 032918) |
| Enumeration Date | 2014-08-27 |
| Last Update Date | 2014-08-27 |