Provider Demographics
NPI:1003859968
Name:RESTREPO, DAVID R (PHARMACIST)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:R
Last Name:RESTREPO
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:117 BARLOW DR S
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11234-6721
Mailing Address - Country:US
Mailing Address - Phone:347-782-1128
Mailing Address - Fax:718-265-1406
Practice Address - Street 1:1235 1ST AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-6311
Practice Address - Country:US
Practice Address - Phone:212-628-1110
Practice Address - Fax:212-628-1117
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY48901183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist