MEDICARE: MR. GORDON CHIN 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	036352	NY

General Provider Information

NPI Number	:	1992961635
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. GORDON CHIN RPH

Provider Business Mailing Address
First Line	:	94 DAVID AVE
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14620-3104
Country	:	US
Telephone Number	:	585-442-2794
Fax Number	:

Provider Business Practice Location Address
First Line	:	94 DAVID AVE
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14620-3104
Country	:	US
Telephone Number	:	585-442-2794
Fax Number	:

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

Provider Enumeration Date	:	08/01/2008
Last Update Date	:	04/25/2011

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Directions to “ MR. GORDON CHIN RPH” Practice Location

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