MEDICARE: MARIA MICHAEL

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	070294	NY

General Provider Information

NPI Number	:	1255156527
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIA MICHAEL

Provider Business Mailing Address
First Line	:	30 DENNIS ST
Second Line	:
City	:	GARDEN CITY PARK
State	:	NY
Zip	:	11040-5044
Country	:	US
Telephone Number	:	516-637-3148
Fax Number	:

Provider Business Practice Location Address
First Line	:	421 GLEN COVE RD
Second Line	:
City	:	ROSLYN HEIGHTS
State	:	NY
Zip	:	11577-1811
Country	:	US
Telephone Number	:	516-621-5959
Fax Number	:

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

Provider Enumeration Date	:	11/20/2024
Last Update Date	:	11/20/2024

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Directions to “ MARIA MICHAEL ” Practice Location

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