Healthcare Provider Details

I. General information

NPI: 1568513828
Provider Name (Legal Business Name): PAUL JOSEPH FAERSTEIN PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/15/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

252 BRIGHTON BEACH AVE
BROOKLYN NY
11235-7427
US

IV. Provider business mailing address

136 EXETER ST
BROOKLYN NY
11235-3724
US

V. Phone/Fax

Practice location:
  • Phone: 718-646-2222
  • Fax:
Mailing address:
  • Phone: 646-240-8884
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number028150
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: