Individual
ANNA DECOLONGON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARM D.
Contact information
Practice address
125 E 86TH ST, NEW YORK, NY 10028-1008
(212) 996-5261
Mailing address
8426 ELIOT AVE, MIDDLE VILLAGE, NY 11379-1417
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
055472
NY
Other
Enumeration date
02/15/2011
Last updated
02/15/2011
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