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General NPI Number Information
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NPI Number | 1487172102
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Entity Type | Organization
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Legal Business Name | M & D ELITE PHARMACY LLC
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Dates
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Enumeration Date | 09/01/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 239-19 BRADDOCK AVE
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City | JAMAICA
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State | NY
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Zip | 11426-7209
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Country | US
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Telephone | 646-568-6448
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Fax | 646-568-6449
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Provider Business Mailing Address
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Address Line | 239-19 BRADDOCK AVE
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City | JAMAICA
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State | NY
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Zip | 11426-7209
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Country | US
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Telephone | 646-568-6448
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Fax | 646-568-6449
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Authorized Official
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Title or Position | PRESIDENT
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Name | MARAT ZAGORIN
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Credential |
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Telephone | 646-568-6448
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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 |
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License Number State |
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