Individual
DR. CHARLES BREITSTADT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
6221 NY-25A, WADING RIVER, NY 11792
(631) 929-6040
Mailing address
1600 PINE NECK RD, SOUTHOLD, NY 11971-3403
(614) 226-4572
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
066652
NY
Other
Enumeration date
01/05/2021
Last updated
01/05/2021
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