Provider Demographics
NPI:1760401160
Name:HOPKINS, ROBERT JOHN (RPH)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:JOHN
Last Name:HOPKINS
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5737 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11355-5332
Mailing Address - Country:US
Mailing Address - Phone:718-762-7111
Mailing Address - Fax:718-764-6491
Practice Address - Street 1:5737 MAIN ST
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11355-5332
Practice Address - Country:US
Practice Address - Phone:718-762-7111
Practice Address - Fax:718-764-6491
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-18
Last Update Date:2018-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY030836183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02290646Medicaid
NY02290646Medicaid