Organization
NUEVA LUZ PHARMACY INC
Active
Other names
NUEVA LUZ PHARMACY INC
Organization subpart
No
Provider details
NPI number
Authorized official
DIANA RESTREPO (PRESIDENT)
(718) 406-9040
Entity
Organization
Contact information
Practice address
8009 37TH AVE, JACKSON HEIGHTS, NY 11372-6719
(718) 406-9040
(718) 255-6129
Mailing address
8009 37TH AVE, JACKSON HEIGHTS, NY 11372-6719
(718) 406-9040
(718) 255-6129
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
034767
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2160852
PK
—
Enumeration date
04/22/2016
Last updated
07/14/2016
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