Individual
ALISARA ARANYAVICKUL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.PH
Contact information
Practice address
918 MAIN ST, FARMINGDALE, NY 11735-5426
(516) 845-5235
Mailing address
3950 60TH ST APT A35, WOODSIDE, NY 11377-3421
(646) 639-5331
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
061147
NY
Other
Enumeration date
09/20/2015
Last updated
09/20/2015
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