MEDICARE: DUANE READE

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	332B00000X	Durable Medical Equipment & Medical Supplies
2	3336C0003X	Community/Retail Pharmacy
3	333600000X	Pharmacy	025395	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	3315492	OTHER		OTHER ID NUMBER-COMMERCIAL NUMBER
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1548285018
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DUANE READE

Provider Business Mailing Address
First Line	:	1901 E VOORHEES ST
Second Line	:	MS 790
City	:	DANVILLE
State	:	IL
Zip	:	61834-4515
Country	:	US
Telephone Number	:	847-527-2489
Fax Number	:	217-709-2344

Provider Business Practice Location Address
First Line	:	1320 STONY BROOK RD STE 160
Second Line	:
City	:	STONY BROOK
State	:	NY
Zip	:	11790-2229
Country	:	US
Telephone Number	:	631-751-5743
Fax Number	:	631-751-5987

Authorized Official
Title or Position	:	MANAGER
Name	:	JENNIFER PONCE
Credential	:
Telephone Number	:	847-527-2489

Provider Enumeration Date	:	07/13/2006
Last Update Date	:	05/14/2026

Similar Medicare Providers

1235290644 — JANET TRABOSH P.A.
Practice Location Address:

1320 STONY BROOK RD STE E
STONY BROOK, NY
11790-2229

Practice Phone: 631-444-9404
Practice Fax:

1306027990 — AURA OLINDA TUZINOWSKI RPH
Practice Location Address:

1320 STONY BROOK RD STE 160
STONY BROOK, NY
11790-2229

Practice Phone: 631-751-5743
Practice Fax: 631-751-5987

1639181456 — TRICORE WEST, LLC
Practice Location Address:

8685 QUEENS BROOK CT
LAS VEGAS, NV
89129-2229

Practice Phone: 702-838-8558
Practice Fax: 702-873-6880

1639343536 — TODD J ZANG DPM LTD
Practice Location Address:

8685 QUEENS BROOK CT
LAS VEGAS, NV
89129-2229

Practice Phone: 702-838-8558
Practice Fax:

1699115121 — MS. JULIE ANN MOULIN LCSW
Practice Location Address:

165 BETSY BROWN RD
RYE BROOK, NY
10573-2229

Practice Phone: 347-361-5825
Practice Fax:

1598438111 — EILEEN B DIENER LMSW
Practice Location Address:

424 DEACON BROOK CIR
REISTERSTOWN, MD
21136-2229

Practice Phone: 410-458-5944
Practice Fax:

Directions to “DUANE READE ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.