MEDICARE: LITAL LEFF 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	051221-1	NY

General Provider Information

NPI Number	:	1790019966
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LITAL LEFF PHARM.D.

Provider Business Mailing Address
First Line	:	100 W BROADWAY
Second Line	:	APT. 2BB
City	:	LONG BEACH
State	:	NY
Zip	:	11561-4049
Country	:	US
Telephone Number	:	516-670-8747
Fax Number	:	516-977-3166

Provider Business Practice Location Address
First Line	:	100 W BROADWAY
Second Line	:	APT. 2BB
City	:	LONG BEACH
State	:	NY
Zip	:	11561-4049
Country	:	US
Telephone Number	:	516-670-8747
Fax Number	:	516-977-3166

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

Provider Enumeration Date	:	09/21/2009
Last Update Date	:	09/21/2009

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