Healthcare Provider Details

I. General information

NPI: 1033781331
Provider Name (Legal Business Name): JOSEPH REFAAT ESKANDROUS PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/15/2021
Last Update Date: 07/15/2021
Certification Date: 07/15/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18 HAMPTON RD
SOUTHAMPTON NY
11968-4930
US

IV. Provider business mailing address

6950 CALDWELL AVE
MASPETH NY
11378-2636
US

V. Phone/Fax

Practice location:
  • Phone: 631-287-2900
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number066137
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: