MEDICARE: MR. LEONID BABITSKY RPH

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	044362	NY

General Provider Information

NPI Number	:	1861724890
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. LEONID BABITSKY RPH

Provider Business Mailing Address
First Line	:	3610 NOSTRAND AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11229-5203
Country	:	US
Telephone Number	:	718-891-9300
Fax Number	:	718-891-9378

Provider Business Practice Location Address
First Line	:	3610 NOSTRAND AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11229-5203
Country	:	US
Telephone Number	:	718-891-9300
Fax Number	:	718-891-9378

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

Provider Enumeration Date	:	02/01/2010
Last Update Date	:	02/01/2010

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