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General NPI Number Information
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NPI Number | 1568644003
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Entity Type | Individual
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Provider Name | JEREMY ZVI BOIM JR.
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Gender | Male
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Dates
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Enumeration Date | 11/27/2007
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Last Update Date | 11/27/2007
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Provider Practice Location Address
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Address Line | 260 BROADWAY
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City | BROOKLYN
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State | NY
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Zip | 11211-6229
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Country | US
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Telephone | 718-782-3030
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Fax | 718-782-2626
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Provider Business Mailing Address
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Address Line | 768 CENTRAL AVE
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City | WOODMERE
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State | NY
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Zip | 11598-2637
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Country | US
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Telephone | 516-295-9626
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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 | 045912-1
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License Number State | NY
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