MEDICARE: VALERIE HENRY

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	36570	NY

General Provider Information

NPI Number	:	1669788261
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VALERIE HENRY

Provider Business Mailing Address
First Line	:	1706 WATSON AVE
Second Line	:	BRONXDALE PHARMACY
City	:	BRONX
State	:	NY
Zip	:	10472-5408
Country	:	US
Telephone Number	:	718-542-0440
Fax Number	:	718-378-1693

Provider Business Practice Location Address
First Line	:	1706 WATSON AVE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10472-5470
Country	:	US
Telephone Number	:	718-542-0440
Fax Number	:	718-378-1693

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

Provider Enumeration Date	:	08/20/2010
Last Update Date	:	08/20/2010

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Directions to “ VALERIE HENRY ” Practice Location

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