MEDICARE: DR. MARIA MARZELLA SULLI PHARM.D.

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	044567	NY

General Provider Information

NPI Number	:	1427048529
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARIA MARZELLA SULLI PHARM.D.

Provider Business Mailing Address
First Line	:	3488 ROANOKE ST
Second Line	:
City	:	SEAFORD
State	:	NY
Zip	:	11783-3001
Country	:	US
Telephone Number	:	516-732-5365
Fax Number	:

Provider Business Practice Location Address
First Line	:	3266 HEMPSTEAD TPKE
Second Line	:
City	:	LEVITTOWN
State	:	NY
Zip	:	11756-1345
Country	:	US
Telephone Number	:	516-579-2111
Fax Number	:	516-735-5080

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

Provider Enumeration Date	:	10/28/2005
Last Update Date	:	12/01/2008

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