MEDICARE: IRENE PIKER 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	040136	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	040136	OTHER	NY	PHARMACIST LICENSE #

General Provider Information

NPI Number	:	1518280510
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	IRENE PIKER RPH

Provider Business Mailing Address
First Line	:	4294 OCEAN AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11235-3730
Country	:	US
Telephone Number	:	718-615-0541
Fax Number	:

Provider Business Practice Location Address
First Line	:	2240 86TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11214-4139
Country	:	US
Telephone Number	:	718-373-2722
Fax Number	:

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

Provider Enumeration Date	:	03/04/2010
Last Update Date	:	03/04/2010

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Directions to “ IRENE PIKER RPH” Practice Location

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