Individual
MR. BRIAN L WATTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
45 S SERVICE RD, PLAINVIEW, NY 11803-4100
(516) 396-8842
Mailing address
1543 11TH ST, WEST BABYLON, NY 11704-3620
(516) 396-8842
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
043492
NY
Other
Enumeration date
02/17/2010
Last updated
02/17/2010
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