| NPI | 1992057939 |
|---|---|
| Doing Business As | 79TH STREET PHARMACY |
| Entity Type | Organization |
| Authorized Contact | LARRY HAAS Pharmacist 914-552-5340 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: NY 031405) |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2012-10-14 |
| Last Update Date | 2022-11-09 |