MEDICARE: MR. NICHOLAS J BELLOCHI 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	035302	NY

General Provider Information

NPI Number	:	1982722112
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. NICHOLAS J BELLOCHI RPH

Provider Business Mailing Address
First Line	:	189 CONNECTICUT ST
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10307-1521
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	244 ROEBLING ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11211-5664
Country	:	US
Telephone Number	:	718-387-9772
Fax Number	:

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

Provider Enumeration Date	:	03/26/2007
Last Update Date	:	07/08/2007

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