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NPI Code Detail

MEDICARE: MS. AERIEL JYKA MARIE DOMANTAY IRANG

MEDICARE: MS. AERIEL JYKA MARIE DOMANTAY IRANG
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
1183500000XPharmacist072173NY

General Provider Information

NPI Number : 1366263600
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. AERIEL JYKA MARIE DOMANTAY IRANG
Provider Business Mailing Address
First Line : 2611 WEBSTER AVE
Second Line :
City : BRONX
State : NY
Zip : 10458-4845
Country : US
Telephone Number : 718-395-4000
Fax Number :
Provider Business Practice Location Address
First Line : 2611 WEBSTER AVE
Second Line :
City : BRONX
State : NY
Zip : 10458-4845
Country : US
Telephone Number : 718-395-4000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/21/2024
Last Update Date : 10/21/2024

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