=====================================================
General NPI Number Information
=====================================================
NPI Number | 1720302110
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JEFFREY PAPO RPH
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/15/2010
-----------------------------------------------------
Last Update Date | 03/15/2010
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 800 RT 82 SUITE A BLDG 5 TUMINARO PHARMACY
-----------------------------------------------------
City | HOPEWELL JUNCTION
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 12533
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 845-223-7858
-----------------------------------------------------
Fax | 845-223-8271
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 800 RT 82 SUITE A BLDG 5 TUMINARO PHARMACY
-----------------------------------------------------
City | HOPEWELL JUNCTION
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 12533
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 845-223-7858
-----------------------------------------------------
Fax | 845-223-8271
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 183500000X
-----------------------------------------------------
Taxonomy Name | Pharmacist
-----------------------------------------------------
License Number | 045184
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------