MEDICARE: FRANCIS WILLIAM ANGILLY

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	048189	NY

General Provider Information

NPI Number	:	1689852816
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FRANCIS WILLIAM ANGILLY

Provider Business Mailing Address
First Line	:	225 MARVIN ST
Second Line	:
City	:	HOLBROOK
State	:	NY
Zip	:	11741-3318
Country	:	US
Telephone Number	:	631-676-4905
Fax Number	:

Provider Business Practice Location Address
First Line	:	683 OLD COUNTRY RD
Second Line	:
City	:	DIX HILLS
State	:	NY
Zip	:	11746-4613
Country	:	US
Telephone Number	:	631-423-6380
Fax Number	:	631-351-1560

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

Provider Enumeration Date	:	02/11/2008
Last Update Date	:	02/11/2008

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