MEDICARE: MR. HOWARD JONATHAN BRASS 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	036458-1	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	:	1235160821
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. HOWARD JONATHAN BRASS RPH

Provider Business Mailing Address
First Line	:	1018 S CARLEY CT
Second Line	:
City	:	NORTH BELLMORE
State	:	NY
Zip	:	11710-2007
Country	:	US
Telephone Number	:	516-781-7517
Fax Number	:	516-785-0715

Provider Business Practice Location Address
First Line	:	353 NEWBRIDGE RD
Second Line	:
City	:	EAST MEADOW
State	:	NY
Zip	:	11554-4120
Country	:	US
Telephone Number	:	516-785-0120
Fax Number	:	516-785-0715

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

Provider Enumeration Date	:	07/05/2006
Last Update Date	:	07/08/2007

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