Healthcare Provider Details

I. General information

NPI: 1639405517
Provider Name (Legal Business Name): MICHAEL STUART BIGLOW PHARM.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/27/2009
Last Update Date: 02/05/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

585 SCHENECTADY AVE
BROOKLYN NY
11203-1891
US

IV. Provider business mailing address

831 UNION ST APT 2
BROOKLYN NY
11215-1333
US

V. Phone/Fax

Practice location:
  • Phone: 718-604-5000
  • Fax: 718-363-6718
Mailing address:
  • Phone: 917-698-1771
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1835P1300X
TaxonomyPsychiatric Pharmacist
License Number47275
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code1835P1300X
TaxonomyPsychiatric Pharmacist
License Number023615
License Number StateGA
# 3
Primary TaxonomyY
Taxonomy Code1835P1300X
TaxonomyPsychiatric Pharmacist
License Number054904
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: