MEDICARE: ALLA NYURENBERG 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	044347	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1932357167
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALLA NYURENBERG RPH

Provider Business Mailing Address
First Line	:	2511 AVENUE U
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11229-4934
Country	:	US
Telephone Number	:	718-891-7900
Fax Number	:	718-891-5310

Provider Business Practice Location Address
First Line	:	2511 AVENUE U
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11229-4934
Country	:	US
Telephone Number	:	718-891-7900
Fax Number	:	718-891-5310

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

Provider Enumeration Date	:	08/29/2008
Last Update Date	:	08/29/2008

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