Organization
KEANES FAMILY PHARMACY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NAGI REDDY PALLAPOLU (PRESIDENT)
(212) 368-3777
Entity
Organization
Contact information
Practice address
586 LENOX AVE, NEW YORK, NY 10037-1201
(212) 368-3777
Mailing address
586 LENOX AVE, NEW YORK, NY 10037-1201
(212) 368-3777
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
034334
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
034334
NEW YORK STATE BOARD OF PHARMACY
NY
Enumeration date
03/14/2016
Last updated
03/14/2016
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