MEDICARE: MR. CEM U GOKHAN 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	036070	NY

General Provider Information

NPI Number	:	1396060240
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. CEM U GOKHAN RPH

Provider Business Mailing Address
First Line	:	1901 FIRST AVENUE
Second Line	:	PHARMACY DEPARTMENT
City	:	NEW YORK
State	:	NY
Zip	:	10029-7491
Country	:	US
Telephone Number	:	212-423-6474
Fax Number	:	212-423-6661

Provider Business Practice Location Address
First Line	:	1901 FIRST AVENUE
Second Line	:	PHARMACY DEPARTMENT
City	:	NEW YORK
State	:	NY
Zip	:	10029-7491
Country	:	US
Telephone Number	:	212-423-6474
Fax Number	:	212-423-6661

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

Provider Enumeration Date	:	04/05/2010
Last Update Date	:	04/05/2010

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