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General NPI Number Information
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NPI Number | 1902631807
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Entity Type | Individual
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Provider Name | GABRIEL JAVIER
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Gender | Male
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Dates
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Enumeration Date | 09/03/2024
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Last Update Date | 09/03/2024
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Provider Practice Location Address
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Address Line | 5560 MYRTLE AVE
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City | RIDGEWOOD
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State | NY
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Zip | 11385-3554
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Country | US
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Telephone | 718-456-8555
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Fax |
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Provider Business Mailing Address
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Address Line | 4520 UTOPIA PKWY
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City | FLUSHING
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State | NY
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Zip | 11358-3331
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Country | US
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Telephone | 646-229-3873
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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 | 071863
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License Number State | NY
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