MEDICARE: MR. MICHAEL A ESEMPLARE 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	24819	NY

General Provider Information

NPI Number	:	1629029590
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. MICHAEL A ESEMPLARE RPH

Provider Business Mailing Address
First Line	:	43 RIVERVIEW CT
Second Line	:
City	:	OAKDALE
State	:	NY
Zip	:	11769-2309
Country	:	US
Telephone Number	:	631-567-3369
Fax Number	:

Provider Business Practice Location Address
First Line	:	604 UNION BLVD
Second Line	:
City	:	WEST ISLIP
State	:	NY
Zip	:	11795-3113
Country	:	US
Telephone Number	:	631-661-6166
Fax Number	:

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

Provider Enumeration Date	:	05/15/2006
Last Update Date	:	07/08/2007

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