MEDICARE: MR. ANTHONY MLADINOV R.PH.

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	33456	NY

General Provider Information

NPI Number	:	1588713424
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ANTHONY MLADINOV R.PH.

Provider Business Mailing Address
First Line	:	87 SCARCLIFFE DR
Second Line	:
City	:	MALVERNE
State	:	NY
Zip	:	11565-1049
Country	:	US
Telephone Number	:	212-724-1950
Fax Number	:

Provider Business Practice Location Address
First Line	:	2260 BROADWAY
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10024-5403
Country	:	US
Telephone Number	:	212-724-1950
Fax Number	:	212-724-1946

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

Provider Enumeration Date	:	01/09/2007
Last Update Date	:	07/08/2007

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