Individual
WALTER JAIRO BOCANUMENTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
8106 BAXTER AVE, ELMHURST PHARMACY & HOME INFUSION, ELMHURST, NY 11373-1385
(718) 507-2299
(718) 507-2399
Mailing address
8106 BAXTER AVE, ELMHURST PHARMACY & HOME INFUSION, ELMHURST, NY 11373-1385
(718) 507-2299
(718) 507-2399
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
10015616
NY
Other
Enumeration date
06/25/2013
Last updated
06/25/2013
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