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NPI Code Detail

MEDICARE: DANA WELLS

MEDICARE: DANA WELLS
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
1183500000XPharmacist052847NY

General Provider Information

NPI Number : 1295058147
Entity Type Code : Individual
Provider Name (Legal Business Name) : DANA WELLS
Provider Business Mailing Address
First Line : 519 GATEWAY DR
Second Line : T-1401
City : BROOKLYN
State : NY
Zip : 11239-2801
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 519 GATEWAY DR
Second Line : T-1401
City : BROOKLYN
State : NY
Zip : 11239-2801
Country : US
Telephone Number : 718-235-7139
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/07/2010
Last Update Date : 03/07/2010

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Directions to “ DANA WELLS ” Practice Location

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