Glenridge Pharmacy LLC

NPI #1174052096 in Glendale, New York

Provider Information

NPI Number: 1174052096
Entity Type: Organization
Organization Name: Glenridge Pharmacy LLC
Primary Specialty: Pharmacy
Enumeration Date: Jun 5, 2017
Last Updated: Jun 5, 2017

Practice Location

Address: 6801 MYRTLE AVE
City: Glendale
State: New York
ZIP Code: 11385-7267
Phone: (718) 366-3561

Authorized Official

Name: DANIEL CAPUSANO
Title: OWNER
Phone: (347) 865-1269

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pharmacy	333600000X	Primary

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