MEDICARE: MRS. MICHELLE LYNNE MEYER 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	060799	NY

General Provider Information

NPI Number	:	1366109456
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MICHELLE LYNNE MEYER RPH

Provider Business Mailing Address
First Line	:	312 GREENWICH ST # 312A
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10013-2703
Country	:	US
Telephone Number	:	914-774-5859
Fax Number	:

Provider Business Practice Location Address
First Line	:	850 3RD AVE STE 404
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11232-1523
Country	:	US
Telephone Number	:	855-687-8369
Fax Number	:

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

Provider Enumeration Date	:	11/23/2021
Last Update Date	:	11/23/2021

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