MEDICARE: MR. MITCHELL N GERSHOWITZ 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
1	183500000X	Pharmacist	32187	NY

General Provider Information

NPI Number	:	1336385962
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. MITCHELL N GERSHOWITZ RPH

Provider Business Mailing Address
First Line	:	2606 BELLMORE AVE
Second Line	:
City	:	BELLMORE
State	:	NY
Zip	:	11710-4308
Country	:	US
Telephone Number	:	516-316-5338
Fax Number	:

Provider Business Practice Location Address
First Line	:	27103 80TH AVE
Second Line	:
City	:	NEW HYDE PARK
State	:	NY
Zip	:	11040-1610
Country	:	US
Telephone Number	:	516-470-1000
Fax Number	:	516-470-1020

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

Provider Enumeration Date	:	01/03/2009
Last Update Date	:	01/03/2009

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