Provider Demographics
NPI:1336385962
Name:GERSHOWITZ, MITCHELL N (RPH)
Entity Type:Individual
Prefix:MR
First Name:MITCHELL
Middle Name:N
Last Name:GERSHOWITZ
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 1:2606 BELLMORE AVE
Mailing Address - Street 2:
Mailing Address - City:BELLMORE
Mailing Address - State:NY
Mailing Address - Zip Code:11710-4308
Mailing Address - Country:US
Mailing Address - Phone:516-316-5338
Mailing Address - Fax:
Practice Address - Street 1:27103 80TH AVE
Practice Address - Street 2:
Practice Address - City:NEW HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:11040-1610
Practice Address - Country:US
Practice Address - Phone:516-470-1000
Practice Address - Fax:516-470-1020
Is Sole Proprietor?:No
Enumeration Date:2009-01-03
Last Update Date:2009-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY32187183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist