Provider Demographics
NPI:1720368491
Name:PRESCRIPTION DYNAMICS
Entity Type:Organization
Organization Name:PRESCRIPTION DYNAMICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:DE GIGLIO
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:914-419-3010
Mailing Address - Street 1:85 CHESTNUT RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:MONTVALE
Mailing Address - State:NJ
Mailing Address - Zip Code:07645-1827
Mailing Address - Country:US
Mailing Address - Phone:914-419-3010
Mailing Address - Fax:
Practice Address - Street 1:85 CHESTNUT RIDGE RD
Practice Address - Street 2:
Practice Address - City:MONTVALE
Practice Address - State:NJ
Practice Address - Zip Code:07645-1827
Practice Address - Country:US
Practice Address - Phone:914-419-3010
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-25
Last Update Date:2011-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0004XSuppliersPharmacyCompounding Pharmacy