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NPI Code Detail

MEDICARE: MR. FRED B MAFFEI RPH

MEDICARE: MR. FRED B MAFFEI 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
1183500000XPharmacist027909NY

General Provider Information

NPI Number : 1083945174
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. FRED B MAFFEI RPH
Provider Business Mailing Address
First Line : 99 PARK DR N
Second Line :
City : STATEN ISLAND
State : NY
Zip : 10314-5702
Country : US
Telephone Number : 718-698-2180
Fax Number : 718-828-7491
Provider Business Practice Location Address
First Line : 2941 WESTCHESTER AVE
Second Line :
City : BRONX
State : NY
Zip : 10461-4534
Country : US
Telephone Number : 718-823-1085
Fax Number : 718-828-7491
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/29/2010
Last Update Date : 01/29/2010

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Directions to “ MR. FRED B MAFFEI RPH” Practice Location

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