MEDICARE: MR. THOMAS J NOWIERSKI 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	27939	NY

General Provider Information

NPI Number	:	1669527966
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. THOMAS J NOWIERSKI RPH

Provider Business Mailing Address
First Line	:	26910 GRAND CENTRAL PKWY
Second Line	:
City	:	FLORAL PARK
State	:	NY
Zip	:	11005-1045
Country	:	US
Telephone Number	:	718-224-3410
Fax Number	:	718-224-3410

Provider Business Practice Location Address
First Line	:	26910 GRAND CENTRAL PKWY
Second Line	:
City	:	FLORAL PARK
State	:	NY
Zip	:	11005-1045
Country	:	US
Telephone Number	:	718-224-3410
Fax Number	:	718-224-3410

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

Provider Enumeration Date	:	01/24/2007
Last Update Date	:	07/08/2007

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