| NPI | 1902931033 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RONALD EDELSTEIN Supervising Pharmacist 718-963-7222 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy (Licence: NY 025951) |
| Enumeration Date | 2007-02-22 |
| Last Update Date | 2020-08-22 |