Provider Demographics
NPI:1649450230
Name:CLINE, WILLIAM RICHARD SR (RPH)
Entity type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:RICHARD
Last Name:CLINE
Suffix:SR
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 1:17 SKIMMER LN
Mailing Address - Street 2:
Mailing Address - City:LEVITTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:11756-2007
Mailing Address - Country:US
Mailing Address - Phone:516-579-3643
Mailing Address - Fax:
Practice Address - Street 1:1012 RAILROAD AVE
Practice Address - Street 2:
Practice Address - City:WOODMERE
Practice Address - State:NY
Practice Address - Zip Code:11598-1645
Practice Address - Country:US
Practice Address - Phone:516-295-1166
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-12
Last Update Date:2007-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY030453183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00267661Medicaid