MEDICARE: DR. ANNA NOGID PHARMD, BCPS

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	047726	NY
2	1835P0018X	Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist	047726	NY
3	1835P1200X	Pharmacotherapy Pharmacist	047726	NY

General Provider Information

NPI Number	:	1073835203
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANNA NOGID PHARMD, BCPS

Provider Business Mailing Address
First Line	:	72 RARITAN AVE
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10304-4012
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	75 DEKALB AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11201-5423
Country	:	US
Telephone Number	:	718-488-1270
Fax Number	:	718-780-4056

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

Provider Enumeration Date	:	02/15/2010
Last Update Date	:	02/15/2010

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