MEDICARE: EKMEL GENCER RPH

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	044758	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1114067758
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EKMEL GENCER RPH

Provider Business Mailing Address
First Line	:	79 HURD ST
Second Line	:
City	:	MINE HILL
State	:	NJ
Zip	:	07803
Country	:	US
Telephone Number	:	973-537-0347
Fax Number	:

Provider Business Practice Location Address
First Line	:	5721 5TH AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11220-3853
Country	:	US
Telephone Number	:	718-439-3500
Fax Number	:	718-439-5207

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

Provider Enumeration Date	:	02/06/2007
Last Update Date	:	07/08/2007

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