MEDICARE: MR. HENRY MARCONI R.PH.

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	042266	NY

General Provider Information

NPI Number	:	1487831251
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. HENRY MARCONI R.PH.

Provider Business Mailing Address
First Line	:	2145 BELLMORE AVE
Second Line	:
City	:	BELLMORE
State	:	NY
Zip	:	11710-5607
Country	:	US
Telephone Number	:	516-221-7694
Fax Number	:	516-409-0903

Provider Business Practice Location Address
First Line	:	2145 BELLMORE AVE
Second Line	:
City	:	BELLMORE
State	:	NY
Zip	:	11710-5607
Country	:	US
Telephone Number	:	516-221-7694
Fax Number	:	516-409-0903

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

Provider Enumeration Date	:	01/23/2008
Last Update Date	:	01/23/2008

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