MEDICARE: MR. ROBERT H KLIEGER RPH

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	026278-1	NY

General Provider Information

NPI Number	:	1043534308
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ROBERT H KLIEGER RPH

Provider Business Mailing Address
First Line	:	393 MERRICK AVE
Second Line	:
City	:	MERRICK
State	:	NY
Zip	:	11566-2723
Country	:	US
Telephone Number	:	516-868-8133
Fax Number	:	516-379-1755

Provider Business Practice Location Address
First Line	:	393 MERRICK AVE
Second Line	:
City	:	MERRICK
State	:	NY
Zip	:	11566-2723
Country	:	US
Telephone Number	:	516-868-8133
Fax Number	:	516-379-1755

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

Provider Enumeration Date	:	03/16/2010
Last Update Date	:	03/16/2010

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