# AVA KIRELLOUS LTD

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Wellness Pharmacy LTC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1841037165
- **Authorized official:** DAVID P SU (SUPERVISING PHARMACIST)
- **Authorized official phone:** (212) 439-4718

## Contact information

- **Practice address:** 144 W 72ND ST, NEW YORK, NY 10023-3344
- **Practice address phone:** (212) 439-4718
- **Practice address fax:** (212) 439-4719
- **Mailing address:** 144 W 72ND ST, NEW YORK, NY 10023-3344

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336L0003X | Long Term Care Pharmacy | — | NULL | Yes |

## Other

- **Enumeration date:** 07/12/2024
- **Last updated:** 07/12/2024