| NPI | 1962689604 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEROME M WEXLER Supervising Pharmacist 631-246-8735 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: NY 034318) |
| Enumeration Date | 2008-01-24 |
| Last Update Date | 2008-01-24 |