Provider Demographics
NPI:1952554347
Name:WATTS, DAVE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:DAVE
Middle Name:
Last Name:WATTS
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:226 EAST 144TH STREET
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10019-3100
Mailing Address - Country:US
Mailing Address - Phone:718-292-0900
Mailing Address - Fax:
Practice Address - Street 1:226 E 144TH ST
Practice Address - Street 2:2ND FLOOR
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10451-5909
Practice Address - Country:US
Practice Address - Phone:718-292-0900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-29
Last Update Date:2012-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY053039183500000X
NJ28RI03140600183500000X
FLPS42748183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist