Healthcare Provider Details

I. General information

NPI: 1407650252
Provider Name (Legal Business Name): BRIANNA OBAS PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/02/2025
Last Update Date: 04/02/2025
Certification Date: 04/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

114 LONG BEACH RD
ISLAND PARK NY
11558-1439
US

IV. Provider business mailing address

184 WICKSHIRE DR
EAST MEADOW NY
11554-1545
US

V. Phone/Fax

Practice location:
  • Phone: 516-208-6698
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number072528
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: