Provider Demographics
NPI:1952313793
Name:SUMMERS, WILLIAM J (RPH)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:J
Last Name:SUMMERS
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:3840 ORLOFF AVE
Mailing Address - Street 2:APT 3A
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10463-2614
Mailing Address - Country:US
Mailing Address - Phone:718-884-5778
Mailing Address - Fax:
Practice Address - Street 1:666 COURTLANDT AVE
Practice Address - Street 2:MELROSE PHARMACY
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10451-5018
Practice Address - Country:US
Practice Address - Phone:718-292-1856
Practice Address - Fax:718-665-2123
Is Sole Proprietor?:No
Enumeration Date:2006-08-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY036253183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist