| NPI | 1992207823 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDEN KASAEV Supervising Pharmacist 929-290-3397 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: NY 036047) |
| Enumeration Date | 2018-03-07 |
| Last Update Date | 2018-04-09 |