Healthcare Provider Details

I. General information

NPI: 1710086483
Provider Name (Legal Business Name): GEORGE NICHOLAS ALTIERI RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/21/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

130 W KINGSBRIDGE RD
BRONX NY
10468-3904
US

IV. Provider business mailing address

25 TRINITY PL
NEW ROCHELLE NY
10805-2635
US

V. Phone/Fax

Practice location:
  • Phone: 718-584-9000
  • Fax:
Mailing address:
  • Phone: 914-637-0054
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number030072-1
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code1835N1003X
TaxonomyNutrition Support Pharmacist
License Number030072-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: