Individual
BEKA KABANASHVILI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
122 W 146TH ST, NEW YORK, NY 10039-3802
(212) 675-3900
Mailing address
292 WILSON AVE, FAIRVIEW, NJ 07022-2033
(201) 667-8000
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
068961
NY
Other
Enumeration date
12/12/2022
Last updated
12/12/2022
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