MEDICARE: DR. EUNAH TODARELLO

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	I054430	NY

General Provider Information

NPI Number	:	1396054474
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. EUNAH TODARELLO

Provider Business Mailing Address
First Line	:	2850 ROUTE 112
Second Line	:
City	:	MEDFORD
State	:	NY
Zip	:	11763-1404
Country	:	US
Telephone Number	:	631-696-4018
Fax Number	:	631-696-4074

Provider Business Practice Location Address
First Line	:	2850 ROUTE 112
Second Line	:
City	:	MEDFORD
State	:	NY
Zip	:	11763-1404
Country	:	US
Telephone Number	:	631-696-4018
Fax Number	:	631-696-4074

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

Provider Enumeration Date	:	10/06/2010
Last Update Date	:	12/12/2011

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Directions to “ DR. EUNAH TODARELLO ” Practice Location

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