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NPI Code Detail

MEDICARE: GREGORY MICHAEL

MEDICARE:   GREGORY  MICHAEL
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
1183500000XPharmacist044539NY

General Provider Information

NPI Number : 1912021981
Entity Type Code : Individual
Provider Name (Legal Business Name) : GREGORY MICHAEL
Provider Business Mailing Address
First Line : 2922 NOSTRAND AVE
Second Line : APT #3F
City : BROOKLYN
State : NY
Zip : 11229-1859
Country : US
Telephone Number : 718-891-2861
Fax Number :
Provider Business Practice Location Address
First Line : 511 BRIGHTON BEACH AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11235-6403
Country : US
Telephone Number : 718-332-4002
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/16/2007
Last Update Date : 09/24/2014

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