Individual
DR. ALQUON HAILSTOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
215 PARK AVE S, NEW YORK, NY 10003-1603
(646) 602-8237
Mailing address
36 DECATUR ST, BROOKLYN, NY 11216-2504
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
064977
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02053987
—
NY
Enumeration date
11/16/2020
Last updated
11/18/2020
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