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NPI Code Detail

MEDICARE: OLGA PORTNOY PHARMACIST

MEDICARE:   OLGA  PORTNOY  PHARMACIST
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
1183500000XPharmacist047832NY

General Provider Information

NPI Number : 1285957621
Entity Type Code : Individual
Provider Name (Legal Business Name) : OLGA PORTNOY PHARMACIST
Provider Business Mailing Address
First Line : 35 FLAGSHIP CIR
Second Line :
City : STATEN ISLAND
State : NY
Zip : 10309-3981
Country : US
Telephone Number : 917-545-0375
Fax Number :
Provider Business Practice Location Address
First Line : 174 AVENUE O
Second Line :
City : BROOKLYN
State : NY
Zip : 11204-4918
Country : US
Telephone Number : 917-545-0375
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/11/2010
Last Update Date : 03/11/2010

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Directions to “ OLGA PORTNOY PHARMACIST” Practice Location

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