Healthcare Provider Details

I. General information

NPI: 1023033586
Provider Name (Legal Business Name): A&P LIVE BETTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/13/2006
Last Update Date: 05/10/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1515 ROUTE 22
BREWSTER NY
10509-4042
US

IV. Provider business mailing address

PO BOX 416369
BOSTON MA
02241-6369
US

V. Phone/Fax

Practice location:
  • Phone: 845-278-5284
  • Fax: 845-278-5287
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number031358
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: SUSAN KIJOWSKI
Title or Position: MANAGER, REGULATORY COMPLIANCE
Credential:
Phone: 201-571-8326