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NPI Code Detail

MEDICARE: MR. JONATHAN R SHAATAL MS, RPH

MEDICARE: MR. JONATHAN R SHAATAL MS, 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
1183500000XPharmacist035887NY

Other Identifiers

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

General Provider Information

NPI Number : 1184894156
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. JONATHAN R SHAATAL MS, RPH
Provider Business Mailing Address
First Line : 1222 E 96TH ST
Second Line :
City : BROOKLYN
State : NY
Zip : 11236-3903
Country : US
Telephone Number : 718-688-8755
Fax Number :
Provider Business Practice Location Address
First Line : 1222 E 96TH ST
Second Line :
City : BROOKLYN
State : NY
Zip : 11236-3903
Country : US
Telephone Number : 718-688-8755
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/06/2008
Last Update Date : 12/26/2018

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