MEDICARE: MAXIMILIAN LITOVSKY

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	051905	NY

General Provider Information

NPI Number	:	1538397377
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MAXIMILIAN LITOVSKY

Provider Business Mailing Address
First Line	:	6505 MYRTLE AVE
Second Line	:
City	:	GLENDALE
State	:	NY
Zip	:	11385-6248
Country	:	US
Telephone Number	:	718-381-5100
Fax Number	:

Provider Business Practice Location Address
First Line	:	6505 MYRTLE AVE
Second Line	:
City	:	GLENDALE
State	:	NY
Zip	:	11385-6248
Country	:	US
Telephone Number	:	718-381-5100
Fax Number	:

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

Provider Enumeration Date	:	07/01/2009
Last Update Date	:	10/25/2013

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Directions to “ MAXIMILIAN LITOVSKY ” Practice Location

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