MEDICARE: MIRKE PIERRE-LOUIS 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
1	183500000X	Pharmacist	043018	NY

General Provider Information

NPI Number	:	1871774943
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MIRKE PIERRE-LOUIS RPH

Provider Business Mailing Address
First Line	:	1154 CLARKSON AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11212-2706
Country	:	US
Telephone Number	:	718-345-6355
Fax Number	:	718-385-9775

Provider Business Practice Location Address
First Line	:	1154 CLARKSON AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11212-2706
Country	:	US
Telephone Number	:	718-345-6355
Fax Number	:	718-385-9775

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

Provider Enumeration Date	:	11/16/2007
Last Update Date	:	11/16/2007

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Directions to “ MIRKE PIERRE-LOUIS RPH” Practice Location

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