MEDICARE: LOKEM AUGUSTINE SCOJAY

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	062613	NY

General Provider Information

NPI Number	:	1235663337
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LOKEM AUGUSTINE SCOJAY

Provider Business Mailing Address
First Line	:	1672 PITKIN AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11212-5605
Country	:	US
Telephone Number	:	347-627-4778
Fax Number	:	347-627-4779

Provider Business Practice Location Address
First Line	:	1672 PITKIN AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11212-5605
Country	:	US
Telephone Number	:	347-627-4778
Fax Number	:	347-627-4779

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

Provider Enumeration Date	:	04/14/2017
Last Update Date	:	04/14/2017

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