Provider Demographics
NPI:1427370220
Name:WINTER, MICHAEL FREDERICK (RPH)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:FREDERICK
Last Name:WINTER
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 1:1039 LANCASTER AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11223-5543
Mailing Address - Country:US
Mailing Address - Phone:718-769-9771
Mailing Address - Fax:
Practice Address - Street 1:1039 LANCASTER AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11223-5543
Practice Address - Country:US
Practice Address - Phone:718-769-9771
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-02-20
Last Update Date:2010-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY035657-1183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist