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Individual

ALIANCE R NELSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PHARMD

Contact information

Practice address
16004 JAMAICA AVE, JAMAICA, NY 11432-6110
(718) 558-3987
Mailing address
14 GREENLAWN BLVD, VALLEY STREAM, NY 11580-2011
(516) 792-6587

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
049750
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02842060
NY
Enumeration date
03/07/2008
Last updated
03/07/2008
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