Organization
475 PHARMACY CORP
Active
Other names
MCLEAN PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PETER WAI LAM IP RPH (SUPERVISING PHARMACIST)
(914) 963-0888
Entity
Organization
Contact information
Practice address
642 MCLEAN AVE, YONKERS, NY 10705-4740
(914) 963-0888
(914) 963-3879
Mailing address
642 MCLEAN AVE, YONKERS, NY 10705-4740
(914) 963-0888
(914) 963-3879
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
16925
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00558205
—
NY
Enumeration date
10/24/2006
Last updated
02/19/2008
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