MEDICARE: MR. ALDO A VIRASI 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	031082-1	NY

General Provider Information

NPI Number	:	1760618359
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ALDO A VIRASI R.PH

Provider Business Mailing Address
First Line	:	53 CATSKILL AVE
Second Line	:
City	:	POUGHKEEPSIE
State	:	NY
Zip	:	12603-6401
Country	:	US
Telephone Number	:	845-452-3048
Fax Number	:

Provider Business Practice Location Address
First Line	:	3081 ROUTE 22
Second Line	:	C/O CVS SUITE 3
City	:	DOVER PLAINS
State	:	NY
Zip	:	12522-5933
Country	:	US
Telephone Number	:	845-877-6372
Fax Number	:	845-877-6524

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

Provider Enumeration Date	:	06/09/2009
Last Update Date	:	09/15/2011

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