MEDICARE: MR. IONUT JOHN TEACA PHARMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	049516	NY

General Provider Information

NPI Number	:	1033390539
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. IONUT JOHN TEACA PHARMD

Provider Business Mailing Address
First Line	:	7211 60TH AVE
Second Line	:
City	:	MASPETH
State	:	NY
Zip	:	11378-2909
Country	:	US
Telephone Number	:	718-779-5546
Fax Number	:

Provider Business Practice Location Address
First Line	:	7326 METROPOLITAN AVE
Second Line	:
City	:	MIDDLE VILLAGE
State	:	NY
Zip	:	11379-2635
Country	:	US
Telephone Number	:	718-894-0234
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/26/2007
Last Update Date	:	11/26/2007

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