MEDICARE: VALENTINO JOHN SCOTTO R.PH.

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	035835-1	NY
2	183500000X	Pharmacist	28R103258300	NJ

General Provider Information

NPI Number	:	1629300918
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VALENTINO JOHN SCOTTO R.PH.

Provider Business Mailing Address
First Line	:	805 ROBINWOOD RD
Second Line	:
City	:	TOWNSHIP OF WASHINGTON
State	:	NJ
Zip	:	07676-4210
Country	:	US
Telephone Number	:	201-664-8533
Fax Number	:	718-331-3779

Provider Business Practice Location Address
First Line	:	7407 18TH AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11204-5614
Country	:	US
Telephone Number	:	718-331-5330
Fax Number	:	718-331-3779

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

Provider Enumeration Date	:	02/11/2010
Last Update Date	:	03/03/2010

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