Provider Demographics
NPI:1265644785
Name:DIGREGORIO, SUSAN (RPH)
Entity Type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:
Last Name:DIGREGORIO
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:73 COUNTY COURTHOUSE ROAD
Mailing Address - Street 2:
Mailing Address - City:GARDEN CITY PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11404-5222
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:73 COUNTY COURTHOUSE ROAD
Practice Address - Street 2:
Practice Address - City:GARDEN CITY PARK
Practice Address - State:NY
Practice Address - Zip Code:11404-5222
Practice Address - Country:US
Practice Address - Phone:516-967-3511
Practice Address - Fax:516-414-3745
Is Sole Proprietor?:No
Enumeration Date:2007-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY044090183500000X, 1835G0303X, 1835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered183500000XPharmacy Service ProvidersPharmacist
Not Answered1835G0303XPharmacy Service ProvidersPharmacistGeriatric
Not Answered1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy