Organization
NYPRES PHARMACY INC
Active
Other names
NYPRES Pharmacy Inc
Organization subpart
No
Provider details
NPI number
Authorized official
DIANA GRULLON (PRESIDENT)
(201) 294-9765
Entity
Organization
Contact information
Practice address
1083 SAINT NICHOLAS AVE, STO # 2, NEW YORK, NY 10032-3829
(646) 918-6640
(646) 918-6803
Mailing address
1083 SAINT NICHOLAS AVE, STO # 2, NEW YORK, NY 10032-3829
(646) 918-6640
(646) 918-6803
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
034238
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2158022
PK
—
Enumeration date
02/05/2016
Last updated
09/22/2016
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