Healthcare Provider Details

I. General information

NPI: 1346019346
Provider Name (Legal Business Name): CMD CONSULTANT PHARMACIST PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/01/2024
Last Update Date: 01/01/2024
Certification Date: 12/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1101 BUFFALO ST
ENDICOTT NY
13760-7102
US

IV. Provider business mailing address

PO BOX 537
ENDICOTT NY
13761-0537
US

V. Phone/Fax

Practice location:
  • Phone: 646-797-0985
  • Fax:
Mailing address:
  • Phone: 646-797-0985
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code1835P2201X
TaxonomyAmbulatory Care Pharmacist
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number
License Number State

VIII. Authorized Official

Name: CHRISTINA M DOROSZ
Title or Position: OWNER
Credential: RPH
Phone: 646-797-0985