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NPI Code Detail

MEDICARE: MR. JOHN I PACE RPH

MEDICARE:  MR. JOHN I PACE  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
1183500000XPharmacist39569NY

General Provider Information

NPI Number : 1679759708
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. JOHN I PACE RPH
Provider Business Mailing Address
First Line : 310 GLEN COVE RD
Second Line :
City : ROSLYN HEIGHTS
State : NY
Zip : 11577-1846
Country : US
Telephone Number : 516-621-1185
Fax Number : 516-621-1480
Provider Business Practice Location Address
First Line : 310 GLEN COVE RD
Second Line :
City : ROSLYN HEIGHTS
State : NY
Zip : 11577-1846
Country : US
Telephone Number : 516-621-5959
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/18/2008
Last Update Date : 06/17/2009

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Directions to “ MR. JOHN I PACE RPH” Practice Location

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