Individual
EMAD BOUSHRA BARTLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
7901 BROADWAY, ELMHURST, NY 11373-1329
(718) 334-4000
Mailing address
7105 69TH PL, GLENDALE, NY 11385-7240
(347) 200-8488
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
001159
NY
Other
Enumeration date
12/13/2022
Last updated
12/13/2022
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