Healthcare Provider Details

I. General information

NPI: 1114242583
Provider Name (Legal Business Name): ANDREW ELLIOT EPSTEIN R,PH.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/29/2010
Last Update Date: 03/29/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3402 AVENUE N
BROOKLYN NY
11234-2607
US

IV. Provider business mailing address

2001 E 9TH ST APT 6J
BROOKLYN NY
11223-4145
US

V. Phone/Fax

Practice location:
  • Phone: 718-258-5858
  • Fax: 718-258-2600
Mailing address:
  • Phone: 718-336-7279
  • Fax: 718-258-2600

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number038336
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: