Healthcare Provider Details

I. General information

NPI: 1619319860
Provider Name (Legal Business Name): BEATA MARIA SKOCZYLAS RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/29/2013
Last Update Date: 07/29/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

976 3RD AVE
BROOKLYN NY
11232-2400
US

IV. Provider business mailing address

156 LANGHAM ST
BROOKLYN NY
11235-2302
US

V. Phone/Fax

Practice location:
  • Phone: 718-965-7616
  • Fax:
Mailing address:
  • Phone: 718-368-2846
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number042991
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: