Provider Demographics
NPI:1306027990
Name:TUZINOWSKI, AURA OLINDA (RPH)
Entity Type:Individual
Prefix:
First Name:AURA
Middle Name:OLINDA
Last Name:TUZINOWSKI
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:AURA
Other - Middle Name:OLINDA
Other - Last Name:PONTON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RPH
Mailing Address - Street 1:1320 STONY BROOK RD STE 160
Mailing Address - Street 2:
Mailing Address - City:STONY BROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11790-2229
Mailing Address - Country:US
Mailing Address - Phone:631-751-5743
Mailing Address - Fax:631-751-5987
Practice Address - Street 1:1320 STONY BROOK RD STE 160
Practice Address - Street 2:
Practice Address - City:STONY BROOK
Practice Address - State:NY
Practice Address - Zip Code:11790-2229
Practice Address - Country:US
Practice Address - Phone:631-751-5743
Practice Address - Fax:631-751-5987
Is Sole Proprietor?:No
Enumeration Date:2007-11-24
Last Update Date:2007-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY043466183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist