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General NPI Number Information
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NPI Number | 1497522882
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Entity Type | Individual
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Provider Name | JUSTIN HE PHARMD
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Gender | Male
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Dates
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Enumeration Date | 12/06/2023
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Last Update Date | 12/06/2023
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Provider Practice Location Address
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Address Line | 122 BAY RIDGE AVE
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City | BROOKLYN
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State | NY
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Zip | 11220-5052
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Country | US
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Telephone | 347-497-5585
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Fax |
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Provider Business Mailing Address
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Address Line | 2026 BRAGG ST
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City | BROOKLYN
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State | NY
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Zip | 11229-4020
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Country | US
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Telephone | 347-421-6238
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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 | 070623
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License Number State | NY
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