Provider Demographics
NPI:1710140280
Name:MINUTO, LAUREN (PHARM D)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:
Last Name:MINUTO
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 ROCKAWAY ST
Mailing Address - Street 2:
Mailing Address - City:ISLIP TERRACE
Mailing Address - State:NY
Mailing Address - Zip Code:11752-1017
Mailing Address - Country:US
Mailing Address - Phone:631-650-0627
Mailing Address - Fax:
Practice Address - Street 1:655 E MONTAUK HWY STE 2
Practice Address - Street 2:
Practice Address - City:EAST PATCHOGUE
Practice Address - State:NY
Practice Address - Zip Code:11772-3153
Practice Address - Country:US
Practice Address - Phone:631-447-6282
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-05
Last Update Date:2008-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY051964183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist