Provider Demographics
NPI:1619295318
Name:HENLEY, ROSALYN (RPH, MS)
Entity Type:Individual
Prefix:MS
First Name:ROSALYN
Middle Name:
Last Name:HENLEY
Suffix:
Gender:F
Credentials:RPH, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:681 CLARKSON AVENUE, PHARMACY DEPARTMENT
Mailing Address - Street 2:KINGSBORO PSYCHIATRIC CENTER
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11203-2125
Mailing Address - Country:US
Mailing Address - Phone:718-221-7386
Mailing Address - Fax:718-221-7330
Practice Address - Street 1:681 CLARKSON AVE
Practice Address - Street 2:PHARMACY DEPARTMENT
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11203-2125
Practice Address - Country:US
Practice Address - Phone:718-221-7386
Practice Address - Fax:718-221-7330
Is Sole Proprietor?:No
Enumeration Date:2010-05-06
Last Update Date:2010-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY365361835P1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1300XPharmacy Service ProvidersPharmacistPsychiatric