Provider Demographics
NPI:1235375015
Name:CUNNINGHAM, HENRY P (RPH)
Entity Type:Individual
Prefix:
First Name:HENRY
Middle Name:P
Last Name:CUNNINGHAM
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:93A RUTLAND RD
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11225-5312
Mailing Address - Country:US
Mailing Address - Phone:917-837-5347
Mailing Address - Fax:516-481-4905
Practice Address - Street 1:210 S FRANKLIN ST
Practice Address - Street 2:
Practice Address - City:HEMPSTEAD
Practice Address - State:NY
Practice Address - Zip Code:11550-5613
Practice Address - Country:US
Practice Address - Phone:516-483-1767
Practice Address - Fax:516-481-4905
Is Sole Proprietor?:No
Enumeration Date:2008-12-27
Last Update Date:2008-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY35353183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist