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General NPI Number Information
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NPI Number | 1417209578
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Entity Type | Organization
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Legal Business Name | MOLLOY PHARMA INC
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Dates
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Enumeration Date | 10/12/2012
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 4170 ALBANY POST RD
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City | HYDE PARK
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State | NY
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Zip | 12538-1762
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Country | US
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Telephone | 845-229-8881
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Fax | 845-229-8948
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Provider Business Mailing Address
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Address Line | 4170 ALBANY POST RD
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City | HYDE PARK
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State | NY
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Zip | 12538-1762
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Country | US
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Telephone | 845-229-8881
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Fax | 845-229-8948
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Authorized Official
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Title or Position | PRESIDENT
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Name | KRISHNA CHALUVADI
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Credential |
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Telephone | 845-229-8881
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 031696
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License Number State | NY
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