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General NPI Number Information
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NPI Number | 1700018975
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Entity Type | Individual
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Provider Name | DAVID LOGIUDICE PHARM D.
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Gender | Male
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Dates
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Enumeration Date | 08/20/2009
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Last Update Date | 12/03/2020
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Provider Practice Location Address
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Address Line | 6126 188TH ST
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City | FRESH MEADOWS
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State | NY
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Zip | 11365-2713
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Country | US
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Telephone | 718-454-4433
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Fax | 718-454-8353
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Provider Business Mailing Address
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Address Line | 175 ROCK RD
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City | GLEN ROCK
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State | NJ
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Zip | 07452-1747
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Country | US
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Telephone | 201-445-2857
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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 | 28RI03984400
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License Number State | NJ
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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 | 053252
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License Number State | NY
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