Registry details
Type
Individual
Primary specialty
Pharmacist
Enumerated
May 2, 2014
License(s)
I059035 (NY)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | 3012 3RD AVE | Bronx, NY 10455-1605 | 718-665-6506 |
| LOCATION | 3012 3RD AVE | Bronx, NY 10455-1201 | 718-665-6506 |
Watch this provider
Get a webhook/email the day this provider is added to the OIG-LEIE exclusion list or appears in an FDA enforcement action.