Healthcare Provider Details

I. General information

NPI: 1689105173
Provider Name (Legal Business Name): DANIEL GARBER PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/25/2017
Last Update Date: 03/25/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

325 NEW DORP LN
STATEN ISLAND NY
10306-3005
US

IV. Provider business mailing address

194 KINGDOM AVE
STATEN ISLAND NY
10312-4424
US

V. Phone/Fax

Practice location:
  • Phone: 718-351-3400
  • Fax: 718-351-5400
Mailing address:
  • Phone: 347-570-5796
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number062769
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number28RI03835300
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: