Healthcare Provider Details

I. General information

NPI: 1700108008
Provider Name (Legal Business Name): PHILIP FORLENZA PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/27/2010
Last Update Date: 11/20/2024
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4166 WHITE PLAINS RD
BRONX NY
10466-3020
US

IV. Provider business mailing address

4166 WHITE PLAINS RD.
BRONX NY
10466-3020
US

V. Phone/Fax

Practice location:
  • Phone: 718-925-4114
  • Fax: 718-925-4112
Mailing address:
  • Phone: 718-925-4114
  • Fax: 718-925-4112

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number037472
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: