Healthcare Provider Details

I. General information

NPI: 1699867648
Provider Name (Legal Business Name): MARIA SZCZUPAK B. PHARM, R.PH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/28/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

82-68 164 ST
JAMAICA NY
11432
US

IV. Provider business mailing address

8808 95TH AVE
OZONE PARK NY
11416-1326
US

V. Phone/Fax

Practice location:
  • Phone: 718-883-3826
  • Fax:
Mailing address:
  • Phone: 718-883-3826
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number36254-1
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number36254-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: