Provider Demographics
NPI:1528390671
Name:DEAR, MICHAEL M (PHARMD RPH)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:M
Last Name:DEAR
Suffix:
Gender:M
Credentials:PHARMD RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:490 AVENUE P
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11223-2002
Mailing Address - Country:US
Mailing Address - Phone:718-998-8000
Mailing Address - Fax:718-375-1282
Practice Address - Street 1:490 AVENUE P
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11223-2002
Practice Address - Country:US
Practice Address - Phone:718-998-8000
Practice Address - Fax:718-375-1282
Is Sole Proprietor?:No
Enumeration Date:2010-01-31
Last Update Date:2010-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY051088183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist