Individual
ANDRE TAYLOR-DOMVILLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
8801 QUEENS BLVD, ELMHURST, NY 11373-4449
(718) 760-5655
Mailing address
8801 QUEENS BLVD, ELMHURST, NY 11373-4449
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
061081
NY
Other
Enumeration date
09/07/2015
Last updated
09/07/2015
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