MEDICARE: MANSHAN SANDRA LUN

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	047591	NY

General Provider Information

NPI Number	:	1336471234
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MANSHAN SANDRA LUN

Provider Business Mailing Address
First Line	:	344 VAN SICKLEN ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11223-3802
Country	:	US
Telephone Number	:	718-373-1699
Fax Number	:

Provider Business Practice Location Address
First Line	:	1150 AVENUE OF THE AMERICAS
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10036-2701
Country	:	US
Telephone Number	:	212-221-3588
Fax Number	:	212-730-1328

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

Provider Enumeration Date	:	02/03/2010
Last Update Date	:	02/03/2010

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Directions to “ MANSHAN SANDRA LUN ” Practice Location

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