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General NPI Number Information
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NPI Number | 1194284893
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Entity Type | Organization
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Legal Business Name | MENS HEALTH OF SMITHTOWN
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Dates
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Enumeration Date | 03/13/2019
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Last Update Date | 09/07/2019
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Provider Practice Location Address
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Address Line | 329 E MIDDLE COUNTRY RD STE 8
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City | SMITHTOWN
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State | NY
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Zip | 11787-2821
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Country | US
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Telephone | 631-343-7880
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Fax | 631-343-7710
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Provider Business Mailing Address
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Address Line | 329 E MIDDLE COUNTRY RD STE 8
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City | SMITHTOWN
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State | NY
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Zip | 11787-2821
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Country | US
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Telephone | 631-343-7880
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Fax | 631-343-7881
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Authorized Official
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Title or Position | PRESADENT
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Name | BRIAN MICHAEL KAUFMAN
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Credential | ETC
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Telephone | 631-343-7880
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0002X
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Taxonomy Name | Clinic Pharmacy
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License Number |
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License Number State |
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