Healthcare Provider Details

I. General information

NPI: 1740651249
Provider Name (Legal Business Name): MARIA OGRODOWSKI RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/09/2015
Last Update Date: 10/09/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21 BLOOMINGDALE RD
WHITE PLAINS NY
10605-1504
US

IV. Provider business mailing address

1B VAIL ST
NORWALK CT
06850-2012
US

V. Phone/Fax

Practice location:
  • Phone: 914-682-9100
  • Fax: 914-682-6914
Mailing address:
  • Phone: 203-286-6165
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1300X
TaxonomyPsychiatric Pharmacist
License Number045557
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: