Healthcare Provider Details

I. General information

NPI: 1851571103
Provider Name (Legal Business Name): RONALD R GOLDSTEIN BS PHARM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/04/2007
Last Update Date: 11/04/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

371 HORSEBLOCK RD
FARMINGVILLE NY
11738-1203
US

IV. Provider business mailing address

371 HORSEBLOCK RD
FARMINGVILLE NY
11738-1203
US

V. Phone/Fax

Practice location:
  • Phone: 631-698-2900
  • Fax: 631-698-8215
Mailing address:
  • Phone: 631-698-2900
  • Fax: 631-698-8215

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number027457
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: