99-24 65rd

NPI #1225310923 in Rego Park, New York

Provider Information

NPI Number: 1225310923
Entity Type: Organization
Organization Name: 99-24 65rd
Primary Specialty: Pharmacy
Enumeration Date: Sep 19, 2011
Last Updated: Sep 19, 2011

Practice Location

Address: 9924 65TH RD
City: Rego Park
State: New York
ZIP Code: 11374-3655
Phone: (646) 785-5074

Authorized Official

Name: MISS MAZOL FATAKHOVA
Title: PHARMACIST
Phone: 64678550774

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pharmacy	333600000X	Primary

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