Provider Demographics
NPI:1063656627
Name:GOLDSCHMIDT, LESTER ALLAN (MS, RPH)
Entity Type:Individual
Prefix:MR
First Name:LESTER
Middle Name:ALLAN
Last Name:GOLDSCHMIDT
Suffix:
Gender:M
Credentials:MS, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 STANLEY PL
Mailing Address - Street 2:
Mailing Address - City:HAUPPAUGE
Mailing Address - State:NY
Mailing Address - Zip Code:11788-2717
Mailing Address - Country:US
Mailing Address - Phone:631-286-1854
Mailing Address - Fax:631-862-1854
Practice Address - Street 1:2975 HORSEBLOCK RD
Practice Address - Street 2:TARGET PHARMACY
Practice Address - City:MEDFORD
Practice Address - State:NY
Practice Address - Zip Code:11763-2526
Practice Address - Country:US
Practice Address - Phone:631-286-1854
Practice Address - Fax:631-286-1854
Is Sole Proprietor?:No
Enumeration Date:2009-04-27
Last Update Date:2009-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY026846183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist