Individual
ADOLPHUS TUBIANOSA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
5311 ROOSEVELT AVE, WOODSIDE, NY 11377-4238
(718) 255-6355
Mailing address
6118 BOOTH ST, REGO PARK, NY 11374-1034
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
068809
NY
Other
Enumeration date
09/26/2022
Last updated
09/26/2022
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