Organization
MILL PARK DRUGS INC
Active
Other names
Eltingville Pharmacy Toys & Gifts
Organization subpart
No
Provider details
NPI number
Authorized official
SILVANA MATTIOLI (OWNER/AO)
(718) 356-1789
Entity
Organization
Contact information
Practice address
3948 RICHMOND AVE, STATEN ISLAND, NY 10312-5111
(718) 356-1789
(718) 356-1777
Mailing address
3948 RICHMOND AVE, STATEN ISLAND, NY 10312-5111
(718) 356-1789
(718) 356-1777
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0004X
Compounding Pharmacy
Primary
036468
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00337471
—
NY
01
—
2176079
PK
—
Enumeration date
02/09/2018
Last updated
04/26/2018
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