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General NPI Number Information
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NPI Number | 1013199140
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Entity Type | Individual
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Provider Name | SPIRO PETER MONIAS RPH
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Gender | Male
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Dates
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Enumeration Date | 11/30/2007
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Last Update Date | 11/30/2007
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Provider Practice Location Address
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Address Line | 139 RONKONKOMA AVE
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City | LAKE RONKONKOMA
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State | NY
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Zip | 11779-3339
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Country | US
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Telephone | 631-981-4477
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Fax | 631-981-5225
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Provider Business Mailing Address
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Address Line | 75 RINALDO RD
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City | FORT SALONGA
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State | NY
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Zip | 11768
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Country | US
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Telephone | 516-644-8400
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Fax | 631-981-5225
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 049196
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License Number State | NY
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