MEDICARE: DR. JOSEPH P NATHAN PHARMD

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	041217	NY

General Provider Information

NPI Number	:	1649396763
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOSEPH P NATHAN PHARMD

Provider Business Mailing Address
First Line	:	1709 AVENUE I
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11230-3109
Country	:	US
Telephone Number	:	718-377-2448
Fax Number	:	718-488-1254

Provider Business Practice Location Address
First Line	:	75 DEKALB AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11201-5423
Country	:	US
Telephone Number	:	718-488-1251
Fax Number	:	718-488-1254

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

Provider Enumeration Date	:	03/21/2007
Last Update Date	:	07/08/2007

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