MEDICARE: CHRISTY MEI

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	333600000X	Pharmacy	064550	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	161432544	OTHER	NY	DRIVER'S LICENSE

General Provider Information

NPI Number	:	1790267961
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTY MEI

Provider Business Mailing Address
First Line	:	1574 64TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11219-5730
Country	:	US
Telephone Number	:	917-238-9301
Fax Number	:

Provider Business Practice Location Address
First Line	:	1574 64TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11219-5730
Country	:	US
Telephone Number	:	917-238-9301
Fax Number	:

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

Provider Enumeration Date	:	09/04/2018
Last Update Date	:	09/04/2018

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Directions to “ CHRISTY MEI ” Practice Location

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