Individual
MRS. COLEEN MARIE RADOCAJ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
630 N WELLWOOD AVE, LINDENHURST, NY 11757-1634
(631) 957-2720
Mailing address
15168 23RD AVE, WHITESTONE, NY 11357-3721
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
048738
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00276499
—
NY
Enumeration date
11/01/2007
Last updated
11/01/2007
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