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General NPI Number Information
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NPI Number | 1053634246
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Entity Type | Individual
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Provider Name | LAUREN FORD R.PH.
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Gender | Female
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Dates
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Enumeration Date | 03/02/2010
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Last Update Date | 03/02/2010
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Provider Practice Location Address
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Address Line | 1155 DEER PARK AVE
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City | NORTH BABYLON
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State | NY
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Zip | 11703-3105
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Country | US
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Telephone | 631-667-5030
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Fax | 631-667-0766
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Provider Business Mailing Address
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Address Line | 88 FONDA RD
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City | ROCKVILLE CENTRE
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State | NY
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Zip | 11570-2707
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Country | US
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Telephone | 516-766-1519
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Fax | 516-887-3689
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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 | 035968-1
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License Number State | NY
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