Provider Demographics
NPI:1508189937
Name:MCDONNELL, PATRICK VINCENT (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:VINCENT
Last Name:MCDONNELL
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9408 3RD AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11209-6804
Mailing Address - Country:US
Mailing Address - Phone:718-748-1673
Mailing Address - Fax:718-748-1760
Practice Address - Street 1:9408 3RD AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11209-6804
Practice Address - Country:US
Practice Address - Phone:718-748-1673
Practice Address - Fax:718-748-1760
Is Sole Proprietor?:No
Enumeration Date:2010-03-12
Last Update Date:2010-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY054188183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist