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NPI Code Detail

MEDICARE: MR. MICHAEL J RADUAZZO SR. BSPH

MEDICARE:  MR. MICHAEL J RADUAZZO SR. BSPH
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
1183500000XPharmacist0220221NY

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 : 1225179963
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. MICHAEL J RADUAZZO SR. BSPH
Provider Business Mailing Address
First Line : 196 COW NECK RD
Second Line :
City : PORT WASHINGTON
State : NY
Zip : 11050-1102
Country : US
Telephone Number : 516-883-8869
Fax Number :
Provider Business Practice Location Address
First Line : 196 COW NECK RD
Second Line :
City : PORT WASHINGTON
State : NY
Zip : 11050-1102
Country : US
Telephone Number : 516-883-8869
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/08/2007
Last Update Date : 07/08/2007

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