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General NPI Number Information
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NPI Number | 1730662412
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Entity Type | Organization
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Legal Business Name | GIA & GRAY APOTHECARY INC.
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Dates
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Enumeration Date | 09/10/2018
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Last Update Date | 09/10/2018
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Provider Practice Location Address
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Address Line | 138 W BROADWAY
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City | NEW YORK
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State | NY
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Zip | 10013-3352
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Country | US
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Telephone | 646-915-6347
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Fax |
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Provider Business Mailing Address
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Address Line | 4730 46TH ST APT 3R
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City | WOODSIDE
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State | NY
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Zip | 11377-6541
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Country | US
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Telephone | 646-915-6347
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ARISTIDIS NIKOLITSIS
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Credential |
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Telephone | 646-915-6347
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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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