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Individual

MR. DAVID NUSSBAUM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
777 PULASKI RD, GREENLAWN, NY 11740-1710
(516) 921-5494
Mailing address
61 MELANIE LN, SYOSSET, NY 11791-5119

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
30955
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
30955
PHARMACIST LICENSE
NY
Enumeration date
02/09/2008
Last updated
02/09/2008
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