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General NPI Number Information
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NPI Number | 1821692302
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Entity Type | Individual
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Provider Name | SANDRA MATHELIER
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Gender | Female
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Dates
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Enumeration Date | 11/25/2020
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Last Update Date | 11/25/2020
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Provider Practice Location Address
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Address Line | KEY CARE PHARMACY INC 3411 CHURCH AVE
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City | BROOKLYN
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State | NY
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Zip | 11203
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Country | US
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Telephone | 718-693-1957
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Fax | 718-693-0150
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Provider Business Mailing Address
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Address Line | 21802 99TH AVE
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City | QUEENS VILLAGE
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State | NY
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Zip | 11429-1206
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Country | US
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Telephone | 516-288-4746
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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 | 043628
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License Number State | NY
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