Provider Demographics
NPI:1750559316
Name:TORO, NELLIE (BS RPH)
Entity type:Individual
Prefix:MS
First Name:NELLIE
Middle Name:
Last Name:TORO
Suffix:
Gender:F
Credentials:BS RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:364 PRINGLE ST
Mailing Address - Street 2:
Mailing Address - City:HOLBROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11741-4722
Mailing Address - Country:US
Mailing Address - Phone:631-588-8321
Mailing Address - Fax:
Practice Address - Street 1:812 MONTAUK HWY
Practice Address - Street 2:
Practice Address - City:CENTER MORICHES
Practice Address - State:NY
Practice Address - Zip Code:11934-2212
Practice Address - Country:US
Practice Address - Phone:631-874-9025
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-02-18
Last Update Date:2008-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY032186183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY032186OtherPHARMACIST