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NPI 1972633105

NPI 1972633105 : ROBERT STEVEN WHITEHEAD R.PH : NEW YORK, NY

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General NPI Number Information
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    NPI Number           |    1972633105
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    Entity Type          |    Individual 
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    Provider Name        |    ROBERT STEVEN WHITEHEAD R.PH
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    03/06/2007
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    Last Update Date     |    11/08/2010
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Provider Practice Location Address
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    Address Line         |    1419 6TH AVE 
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    City                 |    NEW YORK
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    State                |    NY
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    Zip                  |    10019-2512
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    Country              |    US
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    Telephone            |    212-247-1538
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    Fax                  |    212-397-0116
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Provider Business Mailing Address
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    Address Line         |    1 COLUMBUS PL #S12D
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    City                 |    NEW YORK
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    State                |    NY
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    Zip                  |    10019-8200
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    Country              |    US
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    Telephone            |    212-365-9797
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    Fax                  |    212-397-0116
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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       |    049778-01
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    License Number State |    NY
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