MEDICARE: ROBERT BONSIGNORE & IRA WIENER PARTNERS

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	333600000X	Pharmacy	15454	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	3303221	OTHER		NABP
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1497820112
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROBERT BONSIGNORE & IRA WIENER PARTNERS

Provider Business Mailing Address
First Line	:	1678 BATH AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11214
Country	:	US
Telephone Number	:	718-256-8413
Fax Number	:	718-256-2154

Provider Business Practice Location Address
First Line	:	1678 BATH AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11214
Country	:	US
Telephone Number	:	718-256-8413
Fax Number	:	718-256-2154

Authorized Official
Title or Position	:	OWNER PHARMACY
Name	:	MR. IRA S WIENER
Credential	:
Telephone Number	:	718-256-8423

Provider Enumeration Date	:	11/21/2006
Last Update Date	:	12/24/2009

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