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NPI Code Detail

MEDICARE: MAYA LANE RPH

MEDICARE: MAYA LANE 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
1183500000XPharmacist047070NY

General Provider Information

NPI Number : 1881807691
Entity Type Code : Individual
Provider Name (Legal Business Name) : MAYA LANE RPH
Provider Business Mailing Address
First Line : 2201 BATH AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11214-5603
Country : US
Telephone Number : 718-372-0797
Fax Number : 718-372-0797
Provider Business Practice Location Address
First Line : 2201 BATH AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11214-5603
Country : US
Telephone Number : 718-372-0797
Fax Number : 718-372-0797
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/08/2007
Last Update Date : 08/26/2008

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Directions to “ MAYA LANE RPH” Practice Location

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