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General NPI Number Information
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NPI Number | 1043502164
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Entity Type | Organization
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Legal Business Name | SANTO DOMINGO PHARMACY, INC
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Dates
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Enumeration Date | 05/08/2011
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Last Update Date | 01/30/2012
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Provider Practice Location Address
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Address Line | 7704 ROOSEVELT AVE
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City | JACKSON HEIGHTS
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State | NY
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Zip | 11372-6610
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Country | US
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Telephone | 718-424-8798
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Fax | 718-205-7168
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Provider Business Mailing Address
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Address Line | 7704 ROOSEVELT AVE
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City | JACKSON HEIGHTS
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State | NY
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Zip | 11372-6610
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Country | US
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Telephone | 718-424-8798
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Fax | 718-205-7168
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | JANARDAN SONI
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Credential |
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Telephone | 848-667-3335
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | 030663
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License Number State | NY
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