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NPI Code Detail

MEDICARE: WILLIAM MISITANO

MEDICARE:   WILLIAM  MISITANO
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
1183500000XPharmacist011369NY

General Provider Information

NPI Number : 1558548974
Entity Type Code : Individual
Provider Name (Legal Business Name) : WILLIAM MISITANO
Provider Business Mailing Address
First Line : 3079 ERWIN PL
Second Line :
City : OCEANSIDE
State : NY
Zip : 11572-4206
Country : US
Telephone Number : 516-678-0115
Fax Number :
Provider Business Practice Location Address
First Line : 594 ATLANTIC AVE
Second Line :
City : EAST ROCKAWAY
State : NY
Zip : 11518-1539
Country : US
Telephone Number : 516-599-2627
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/28/2008
Last Update Date : 01/28/2008

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Directions to “ WILLIAM MISITANO ” Practice Location

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