Organization
DALIZA PHARMACY INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LUIS ANTONIO PEREZ JR. BA BUSINESS (MANAGER)
(212) 281-9410
Entity
Organization
Contact information
Practice address
3481 BROADWAY, NEW YORK, NY 10031-5612
(212) 281-9410
(212) 281-9282
Mailing address
3481 BROADWAY, NEW YORK, NY 10031-5612
(212) 281-9410
(212) 281-9282
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
017113
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00594087
—
NY
Enumeration date
05/09/2007
Last updated
08/22/2020
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