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NPI Code Detail

MEDICARE: DANIEL SHIN PHARM.D

MEDICARE:   DANIEL  SHIN  PHARM.D
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
1183500000XPharmacist062163NY

General Provider Information

NPI Number : 1619426830
Entity Type Code : Individual
Provider Name (Legal Business Name) : DANIEL SHIN PHARM.D
Provider Business Mailing Address
First Line : 2 MARLON LN
Second Line :
City : HAUPPAUGE
State : NY
Zip : 11788-3005
Country : US
Telephone Number : 516-356-3665
Fax Number :
Provider Business Practice Location Address
First Line : 2850 ROUTE 112
Second Line :
City : MEDFORD
State : NY
Zip : 11763-1404
Country : US
Telephone Number : 631-696-4018
Fax Number : 631-696-4074
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/28/2016
Last Update Date : 08/25/2021

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