NPI: 1982726279 · WEST NEW YORK, NJ 07093 · Pharmacy · NPI assigned 04/06/2007
| Authorized Official | DOMINGUEZ, ILEANA (PRESIDENT/PIC) |
| NPI Enumeration Date | 04/06/2007 |
| Year | Claims | Total Paid |
|---|---|---|
| 2020 | 13 | $0.00 |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| G0008 | Administration of influenza virus vaccine | 13 | 13 | $0.00 |