MEDICARE: MR. MICHAEL GERALD SARKUS 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	045926	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1457524621
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. MICHAEL GERALD SARKUS RPH

Provider Business Mailing Address
First Line	:	838 SUNRISE HWY
Second Line	:
City	:	BAY SHORE
State	:	NY
Zip	:	11706-5908
Country	:	US
Telephone Number	:	631-969-8970
Fax Number	:	631-969-8970

Provider Business Practice Location Address
First Line	:	838 SUNRISE HWY
Second Line	:
City	:	BAY SHORE
State	:	NY
Zip	:	11706-5908
Country	:	US
Telephone Number	:	631-969-8970
Fax Number	:	631-969-8970

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

Provider Enumeration Date	:	04/09/2008
Last Update Date	:	04/09/2008

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