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General NPI Number Information
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NPI Number | 1912185190
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Entity Type | Individual
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Provider Name | MAX GILBERT R.P.H
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Gender | Male
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Dates
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Enumeration Date | 02/10/2008
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Last Update Date | 02/10/2008
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Provider Practice Location Address
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Address Line | 2162 NESCONSET HWY
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City | STONY BROOK
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State | NY
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Zip | 11790-3503
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Country | US
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Telephone | 631-444-0968
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Fax | 631-444-0963
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Provider Business Mailing Address
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Address Line | 63 THADFORD ST
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City | EAST NORTHPORT
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State | NY
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Zip | 11731-4940
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Country | US
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Telephone | 631-368-0276
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Fax | 631-368-3980
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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 | 28243
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License Number State | NY
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