Healthcare Provider Details

I. General information

NPI: 1356823777
Provider Name (Legal Business Name): WILLIAM HEUSER PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/01/2018
Last Update Date: 09/01/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

270-05 76TH AVE
NEW HYDE PARK NY
11040
US

IV. Provider business mailing address

74 FROEHLICH FARM ROAD
HICKSVILLE NY
11801
US

V. Phone/Fax

Practice location:
  • Phone: 718-470-7430
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835C0205X
TaxonomyCritical Care Pharmacist
License Number061829
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: