Individual
MR. ALEKSANDR BALAGULOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
598 BROADWAY, NEW YORK, NY 10012-3206
(212) 343-2567
Mailing address
598 BROADWAY, NEW YORK, NY 10012-3206
(212) 343-2567
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
051970
NY
Other
Enumeration date
06/09/2008
Last updated
03/04/2010
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