Registry details
Type
Individual
Primary specialty
Pharmacist
Enumerated
Sep 3, 2006
License(s)
047395 (NY)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 1348 CONEY ISLAND AVE | Brooklyn, NY 11230-4120 | 718-513-6644 |
| MAILING | 17636 KILDARE RD | Jamaica, NY 11432-1413 | 917-576-0497 |
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.