MEDICARE: ROBERT SHINDLER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	029999	NY

General Provider Information

NPI Number	:	1003045824
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT SHINDLER

Provider Business Mailing Address
First Line	:	36 MONMOUTH ROADF
Second Line	:
City	:	GLEN ROCK
State	:	NJ
Zip	:	07452
Country	:	US
Telephone Number	:	201-444-9434
Fax Number	:	718-588-2318

Provider Business Practice Location Address
First Line	:	1340 EDWARD L GRANT HWY
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10452-3144
Country	:	US
Telephone Number	:	718-588-3304
Fax Number	:	718-588-2318

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/14/2009
Last Update Date	:	07/14/2009

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