Healthcare Provider Details

I. General information

NPI: 1346759784
Provider Name (Legal Business Name): CHRISTOPHER JUDE ESPENAS PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/28/2017
Last Update Date: 09/28/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3131 HEMPSTEAD TPKE
LEVITTOWN NY
11756-1318
US

IV. Provider business mailing address

54 POWELL AVE
BETHPAGE NY
11714-3117
US

V. Phone/Fax

Practice location:
  • Phone: 516-731-2990
  • Fax:
Mailing address:
  • Phone: 516-830-1428
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number063470
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: