Healthcare Provider Details

I. General information

NPI: 1023445681
Provider Name (Legal Business Name): TALENE KHOURY RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/27/2013
Last Update Date: 09/27/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

683 BOSTON POST RD
RYE NY
10580-2731
US

IV. Provider business mailing address

683 BOSTON POST RD
RYE NY
10580-2731
US

V. Phone/Fax

Practice location:
  • Phone: 914-715-4298
  • Fax:
Mailing address:
  • Phone: 914-715-4298
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number045806-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: