| NPI | 1922174770 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SANJAY P TRIVEDI Supervising Pharmacist 718-294-7147 |
| Organization Subpart ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NY 027372) |
| Enumeration Date | 2006-11-24 |
| Last Update Date | 2008-02-13 |