Provider Demographics
NPI:1932387420
Name:CZERN, ROBERT M (PHARMACIST)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:M
Last Name:CZERN
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:1934 ROUTE 52
Mailing Address - Street 2:RITE AID PHARMACY #257
Mailing Address - City:LIBERTY
Mailing Address - State:NY
Mailing Address - Zip Code:12754-8310
Mailing Address - Country:US
Mailing Address - Phone:845-292-4114
Mailing Address - Fax:845-292-1147
Practice Address - Street 1:1934 ROUTE 52
Practice Address - Street 2:RITE AID PHARMACY #257
Practice Address - City:LIBERTY
Practice Address - State:NY
Practice Address - Zip Code:12754-8310
Practice Address - Country:US
Practice Address - Phone:845-292-4114
Practice Address - Fax:845-292-1147
Is Sole Proprietor?:No
Enumeration Date:2008-02-06
Last Update Date:2008-02-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY026976183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist