MEDICARE: TOURO COLLEGE

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	333600000X	Pharmacy

General Provider Information

NPI Number	:	1376134239
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TOURO COLLEGE

Provider Business Mailing Address
First Line	:	230 W 125TH ST RM 529
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10027-4402
Country	:	US
Telephone Number	:	212-851-1192
Fax Number	:	212-678-1780

Provider Business Practice Location Address
First Line	:	230 W 125TH ST RM 529
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10027-4402
Country	:	US
Telephone Number	:	212-851-1192
Fax Number	:	212-678-1780

Authorized Official
Title or Position	:	SENIOR DIRECTOR
Name	:	DIPAN B RAY
Credential	:	RPH
Telephone Number	:	212-851-1192

Provider Enumeration Date	:	02/02/2021
Last Update Date	:	02/02/2021

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Directions to “TOURO COLLEGE ” Practice Location

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