MEDICARE: MARINA SLOOTSKY PHARM.D.

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	050627	NY

General Provider Information

NPI Number	:	1164690244
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARINA SLOOTSKY PHARM.D.

Provider Business Mailing Address
First Line	:	3031 AVENUE V
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11229-5448
Country	:	US
Telephone Number	:	718-332-0040
Fax Number	:	718-332-1171

Provider Business Practice Location Address
First Line	:	3031 AVENUE V
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11229-5448
Country	:	US
Telephone Number	:	718-332-0040
Fax Number	:	718-332-1171

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

Provider Enumeration Date	:	02/12/2008
Last Update Date	:	02/12/2008

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