Organization
DITMARS PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. VICTOR DEVAGNO JR. REGISTERED PHARMACIS (PHARMACIST, OWNER)
(718) 278-5454
Entity
Organization
Contact information
Practice address
3308 DITMARS BLVD, ASTORIA, NY 11105-2106
(718) 278-5454
(718) 626-2042
Mailing address
3308 DITMARS BLVD, ASTORIA, NY 11105-2106
(718) 278-5454
(718) 626-2042
Taxonomy
Speciality
Code
Description
License number
State
1835G0303X
Geriatric Pharmacist
Primary
024120
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01902996
—
NY
01
—
3305186
NABP
NY
Enumeration date
12/12/2006
Last updated
08/22/2020
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