MEDICARE: JUAN ALPANO

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	054284	NY

General Provider Information

NPI Number	:	1962762567
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JUAN ALPANO

Provider Business Mailing Address
First Line	:	2246 CLOVE RD
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10305-1524
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	514 BROADWAY
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10310-2804
Country	:	US
Telephone Number	:	718-720-5604
Fax Number	:

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

Provider Enumeration Date	:	05/17/2012
Last Update Date	:	05/17/2012

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Directions to “ JUAN ALPANO ” Practice Location

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