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General NPI Number Information
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NPI Number | 1861679854
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Entity Type | Individual
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Provider Name | MARIE ANTOINETTE CYRIUS
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Gender | Female
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Dates
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Enumeration Date | 01/22/2008
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Last Update Date | 01/22/2008
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Provider Practice Location Address
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Address Line | 85-32 JAMAICA AVE
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City | WOODHAVEN
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State | NY
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Zip | 11421
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Country | US
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Telephone | 718-277-5814
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Fax | 718-277-7599
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Provider Business Mailing Address
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Address Line | 1152 NORTON DR
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City | FAR ROCKAWAY
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State | NY
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Zip | 11691-1739
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Country | US
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Telephone | 718-471-3081
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Fax | 718-471-0089
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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 | 36484
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License Number State | NY
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