Provider Demographics
NPI:1932423084
Name:MORETTO, GARY (PHARMACIST)
Entity Type:Individual
Prefix:
First Name:GARY
Middle Name:
Last Name:MORETTO
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:126 RIDGEVIEW LN
Mailing Address - Street 2:
Mailing Address - City:YORKTOWN HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:10598-5319
Mailing Address - Country:US
Mailing Address - Phone:914-391-8664
Mailing Address - Fax:914-941-4381
Practice Address - Street 1:89 N STATE RD
Practice Address - Street 2:
Practice Address - City:BRIARCLIFF MANOR
Practice Address - State:NY
Practice Address - Zip Code:10510-1415
Practice Address - Country:US
Practice Address - Phone:914-941-1970
Practice Address - Fax:914-941-4381
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-18
Last Update Date:2010-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY034209-1183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist