MEDICARE: JENNIFER PRESS 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	046280	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	046280	OTHER	NY	RPH STATE LICENSE NUMBER

General Provider Information

NPI Number	:	1336317304
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER PRESS RPH

Provider Business Mailing Address
First Line	:	65 SHEPHERD LN
Second Line	:
City	:	LEVITTOWN
State	:	NY
Zip	:	11756-4120
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1530 FRONT ST
Second Line	:
City	:	EAST MEADOW
State	:	NY
Zip	:	11554-2241
Country	:	US
Telephone Number	:	516-483-3256
Fax Number	:

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

Provider Enumeration Date	:	02/13/2008
Last Update Date	:	02/13/2008

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Directions to “ JENNIFER PRESS RPH” Practice Location

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