Healthcare Provider Details

I. General information

NPI: 1932975497
Provider Name (Legal Business Name): PHARMD BRI LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/27/2023
Last Update Date: 11/27/2023
Certification Date: 11/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8 W MAIN ST STE B
PATCHOGUE NY
11772-3039
US

IV. Provider business mailing address

448 VILLAGE GRN
PATCHOGUE NY
11772-3086
US

V. Phone/Fax

Practice location:
  • Phone: 631-828-9936
  • Fax:
Mailing address:
  • Phone: 631-828-9936
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: DR. BRIANNE MARIE WEISS
Title or Position: OWNER/PHARMACIST
Credential: PHARMD
Phone: 631-828-9936