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NPI Code Detail

MEDICARE: MS. VIRGINIA TAGUE

MEDICARE:  MS. VIRGINIA  TAGUE
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
1183500000XPharmacist041625NY

General Provider Information

NPI Number : 1629246483
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. VIRGINIA TAGUE
Provider Business Mailing Address
First Line : 2226 JERICHO TPKE
Second Line :
City : GARDEN CITY PARK
State : NY
Zip : 11040-4708
Country : US
Telephone Number : 516-873-8600
Fax Number :
Provider Business Practice Location Address
First Line : 2226 JERICHO TPKE
Second Line :
City : GARDEN CITY PARK
State : NY
Zip : 11040-4708
Country : US
Telephone Number : 516-873-8600
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/14/2008
Last Update Date : 08/22/2016

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Directions to “ MS. VIRGINIA TAGUE ” Practice Location

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