Organization
MILL PARK DRUGS INC
Active
Other names
Eltingville Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
SILVANA MATTIDI (OWNER)
(715) 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
Primary
016203
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00337471
—
NY
05
—
05180341
—
NY
Enumeration date
09/07/2006
Last updated
09/03/2019
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