Provider Demographics
NPI:1497937544
Name:LINDENBLATT, PAUL (RPH)
Entity Type:Individual
Prefix:MR
First Name:PAUL
Middle Name:
Last Name:LINDENBLATT
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 1:5102 13TH AVE
Mailing Address - Street 2:RITE AID PHARMACY
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11210-4623
Mailing Address - Country:US
Mailing Address - Phone:718-435-5684
Mailing Address - Fax:
Practice Address - Street 1:5102 13TH AVE
Practice Address - Street 2:RITE AID PHARMACY
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11210-4623
Practice Address - Country:US
Practice Address - Phone:718-435-5684
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-30
Last Update Date:2007-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY027505183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01719135Medicaid