Organization
NEW LIFE PHARMACY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERTO DESIRAL (PRESIDENT)
(718) 576-6950
Entity
Organization
Contact information
Practice address
3601 CHURCH AVE, BROOKLYN, NY 11203
(718) 576-6950
(718) 576-6955
Mailing address
3601 CHURCH AVE, BROOKLYN, NY 11203
(718) 576-6950
(718) 576-6955
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
031578
NY
Other
Enumeration date
03/04/2013
Last updated
12/21/2016
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