MEDICARE: MS. JESSICA MARIE TAYLOR R.PH.

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	046142	NY

General Provider Information

NPI Number	:	1851614952
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JESSICA MARIE TAYLOR R.PH.

Provider Business Mailing Address
First Line	:	866 DURHAM RD
Second Line	:
City	:	EAST MEADOW
State	:	NY
Zip	:	11554-4603
Country	:	US
Telephone Number	:	516-564-0037
Fax Number	:

Provider Business Practice Location Address
First Line	:	2034 N JERUSALEM RD
Second Line	:
City	:	NORTH BELLMORE
State	:	NY
Zip	:	11710-1110
Country	:	US
Telephone Number	:	516-481-6654
Fax Number	:

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

Provider Enumeration Date	:	03/04/2010
Last Update Date	:	03/04/2010

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