MEDICARE: CHRISTINA PARVIN PHARM. D

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	058317	NY

General Provider Information

NPI Number	:	1780016527
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTINA PARVIN PHARM. D

Provider Business Mailing Address
First Line	:	19018 HAYWOOD RD
Second Line	:
City	:	HOLLIS
State	:	NY
Zip	:	11423-1159
Country	:	US
Telephone Number	:	718-316-1773
Fax Number	:

Provider Business Practice Location Address
First Line	:	3530 64TH ST
Second Line	:
City	:	WOODSIDE
State	:	NY
Zip	:	11377-2354
Country	:	US
Telephone Number	:	718-424-8825
Fax Number	:

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

Provider Enumeration Date	:	08/03/2013
Last Update Date	:	08/03/2013

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