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Individual

ALIZA MIRIAM GRUNBLATT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PHARMD

Contact information

Practice address
36 LAUREL AVE, SOUTH FALLSBURG, NY 12779-5804
(845) 354-9300
Mailing address
14717 76TH AVE APT 2A, FLUSHING, NY 11367-3168
(347) 693-6751

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
063457
NY

Other

Enumeration date
03/08/2018
Last updated
03/08/2018
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