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General NPI Number Information
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NPI Number | 1194047639
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Entity Type | Individual
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Provider Name | MIRIAM NATHAN-LIFSHITZ
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Gender | Female
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Dates
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Enumeration Date | 02/25/2010
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Last Update Date | 10/02/2019
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Provider Practice Location Address
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Address Line | 3504C JUNCTION BLVD
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City | CORONA
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State | NY
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Zip | 11368-1743
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Country | US
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Telephone | 718-424-4538
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Fax | 718-424-4537
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Provider Business Mailing Address
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Address Line | 160 HOLLYWOOD XING
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City | LAWRENCE
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State | NY
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Zip | 11559-2710
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Country | US
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Telephone | 516-371-5690
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Fax |
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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 | 046153-1
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 0461531
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License Number State | NY
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