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General NPI Number Information
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NPI Number | 1760137236
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Entity Type | Individual
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Provider Name | DANIELLA ROSE BRAY PHARMD
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Gender | Female
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Dates
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Enumeration Date | 02/14/2022
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Last Update Date | 09/04/2022
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Provider Practice Location Address
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Address Line | 3000 MIDDLE COUNTRY RD
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City | NESCONSET
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State | NY
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Zip | 11767-1072
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Country | US
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Telephone | 631-366-0934
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Fax |
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Provider Business Mailing Address
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Address Line | 157 MARK TREE RD
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City | CENTEREACH
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State | NY
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Zip | 11720-2239
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Country | US
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Telephone | 516-983-4928
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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 | 068871
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License Number State | NY
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