Individual
DEIDANIA SCOTT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
799 E 150TH ST, BRONX, NY 10455-4411
(347) 271-5275
(347) 271-5278
Mailing address
799 E 150TH ST, BRONX, NY 10455-4411
(347) 271-5275
(347) 271-5278
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
039194
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
871578604
—
NY
Enumeration date
11/23/2021
Last updated
11/23/2021
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