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General NPI Number Information
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NPI Number | 1801078845
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Entity Type | Individual
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Provider Name | FAYEOFORI MORRISON GODWIN RPH
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Gender | Male
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Dates
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Enumeration Date | 11/30/2007
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Last Update Date | 11/30/2007
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Provider Practice Location Address
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Address Line | 2750 BOSTON RD
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City | BRONX
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State | NY
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Zip | 10469-4127
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Country | US
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Telephone | 718-405-2127
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Fax |
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Provider Business Mailing Address
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Address Line | 1024 E 212TH ST
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City | BRONX
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State | NY
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Zip | 10469-1315
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Country | US
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Telephone | 718-708-4586
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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 | 046997
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License Number State | NY
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