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General NPI Number Information
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NPI Number | 1932381027
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Entity Type | Individual
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Provider Name | DALIA N BOULOS R.PH
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Gender | Female
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Dates
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Enumeration Date | 11/29/2007
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Last Update Date | 11/29/2007
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Provider Practice Location Address
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Address Line | 741 COLUMBUS AVE RITE AID PHARMACY
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City | NEW YORK
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State | NY
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Zip | 10025-6461
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Country | US
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Telephone | 212-316-0436
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Fax |
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Provider Business Mailing Address
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Address Line | 32 HARTLANDER ST
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City | EAST BRUNSWICK
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State | NJ
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Zip | 08816-2667
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Country | US
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Telephone | 732-390-1315
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Fax | 732-257-0881
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 047993-1
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License Number State | NY
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