Provider Demographics
NPI:1518282011
Name:MOLLOY, DENNIS GERARD (RPH (PHARMACIST))
Entity Type:Individual
Prefix:MR
First Name:DENNIS
Middle Name:GERARD
Last Name:MOLLOY
Suffix:
Gender:M
Credentials:RPH (PHARMACIST)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:53 NORTH BROADWAY
Mailing Address - Street 2:L&M PHARMACY ,INC (SMITH PHARMACY)
Mailing Address - City:HICKSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11801
Mailing Address - Country:US
Mailing Address - Phone:516-931-1099
Mailing Address - Fax:516-931-4932
Practice Address - Street 1:53 N BROADWAY
Practice Address - Street 2:SMITH PHARMACY
Practice Address - City:HICKSVILLE
Practice Address - State:NY
Practice Address - Zip Code:11801-2901
Practice Address - Country:US
Practice Address - Phone:516-931-1099
Practice Address - Fax:516-931-4932
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-29
Last Update Date:2010-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY047191-1183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist