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General NPI Number Information
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NPI Number | 1679927867
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Entity Type | Individual
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Provider Name | DANIEL QUILLEN
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Gender | Male
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Dates
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Enumeration Date | 04/14/2016
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Last Update Date | 04/14/2016
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Provider Practice Location Address
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Address Line | 777 N BROADWAY STE 101 PHELPS COMMUNITY PHARMACY
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City | SLEEPY HOLLOW
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State | NY
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Zip | 10591-1019
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Country | US
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Telephone | 914-366-1400
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Fax |
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Provider Business Mailing Address
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Address Line | 27 HEWITT RD
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City | HEWITT
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State | NJ
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Zip | 07421-1105
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Country | US
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Telephone | 267-294-5749
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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 | 060324-1
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License Number State | NY
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