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NPI Code Detail

MEDICARE: MRS. JOSEPHINE PEZZILLO

MEDICARE: MRS. JOSEPHINE PEZZILLO
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
1183500000XPharmacist044919NY

General Provider Information

NPI Number : 1740499680
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. JOSEPHINE PEZZILLO
Provider Business Mailing Address
First Line : 47 GEORGE ST
Second Line :
City : ROSLYN HEIGHTS
State : NY
Zip : 11577-1701
Country : US
Telephone Number : 516-801-2180
Fax Number :
Provider Business Practice Location Address
First Line : 790 PARK PLACE
Second Line :
City : LONG BEACH
State : NY
Zip : 11561-2111
Country : US
Telephone Number : 516-536-0800
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/21/2007
Last Update Date : 07/08/2007

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Directions to “ MRS. JOSEPHINE PEZZILLO ” Practice Location

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