Provider Demographics
NPI:1659363695
Name:CANTALINO, DONALD JAMES (RPH)
Entity Type:Individual
Prefix:MR
First Name:DONALD
Middle Name:JAMES
Last Name:CANTALINO
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:275 WOODLAND DR
Mailing Address - Street 2:
Mailing Address - City:BRIGHTWATERS
Mailing Address - State:NY
Mailing Address - Zip Code:11718-1920
Mailing Address - Country:US
Mailing Address - Phone:631-666-8181
Mailing Address - Fax:631-666-4555
Practice Address - Street 1:546 UNIONDALE AVE
Practice Address - Street 2:
Practice Address - City:UNIONDALE
Practice Address - State:NY
Practice Address - Zip Code:11553-2202
Practice Address - Country:US
Practice Address - Phone:516-486-4333
Practice Address - Fax:516-486-0464
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY035137183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist