Organization
DNA RX 101 CORP
Active
Other names
DIANA'S PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
DIANA NERYAEV RPH (PRESIDENT/PHARMACIST)
(929) 250-2226
Entity
Organization
Contact information
Practice address
6505 MYRTLE AVE, GLENDALE, NY 11385-6248
(929) 250-2226
(929) 250-2263
Mailing address
6505 MYRTLE AVE, GLENDALE, NY 11385-6248
(929) 250-2226
(929) 250-2263
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
3336L0003X
Long Term Care Pharmacy
—
—
Other
Enumeration date
02/18/2020
Last updated
02/18/2020
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