MEDICARE: WILLIAM ALFREDO JAMIESON 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	36435	NY

General Provider Information

NPI Number	:	1629396783
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WILLIAM ALFREDO JAMIESON RPH

Provider Business Mailing Address
First Line	:	303 HERITAGE LN
Second Line	:
City	:	MONROE
State	:	NY
Zip	:	10950-5173
Country	:	US
Telephone Number	:	845-988-7273
Fax Number	:

Provider Business Practice Location Address
First Line	:	542 SOUTHERN BLVD
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10455-3715
Country	:	US
Telephone Number	:	718-665-6771
Fax Number	:	781-866-5104

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

Provider Enumeration Date	:	05/12/2010
Last Update Date	:	05/12/2010

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