Provider Demographics
NPI:1508007253
Name:GERMAN, EDWARD (PHARMD)
Entity Type:Individual
Prefix:MR
First Name:EDWARD
Middle Name:
Last Name:GERMAN
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:126 8TH AVE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10011-5108
Mailing Address - Country:US
Mailing Address - Phone:212-807-8798
Mailing Address - Fax:212-645-8730
Practice Address - Street 1:126 8TH AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-5108
Practice Address - Country:US
Practice Address - Phone:212-807-8798
Practice Address - Fax:212-645-8730
Is Sole Proprietor?:No
Enumeration Date:2009-03-10
Last Update Date:2009-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY45515183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
1248900048OtherMEDICARE PART B SUPPLIER
3353757OtherNABP
NY02118298Medicaid