Provider Demographics
NPI:1841428448
Name:BREWSTER, HAROLD (RPH PHARMACIST)
Entity Type:Individual
Prefix:MR
First Name:HAROLD
Middle Name:
Last Name:BREWSTER
Suffix:
Gender:M
Credentials:RPH PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28 SKYLINE DR
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10304-4814
Mailing Address - Country:US
Mailing Address - Phone:718-720-6873
Mailing Address - Fax:646-672-6543
Practice Address - Street 1:600 E 125TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10035-6000
Practice Address - Country:US
Practice Address - Phone:646-672-6478
Practice Address - Fax:646-672-6484
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-23
Last Update Date:2009-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY031182-1183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist