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Individual

CRYSTAL MCDONALD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
44 TIMBER RIDGE DR, COMMACK, NY 11725-1742
(631) 455-7112
Mailing address
44 TIMBER RIDGE DR, COMMACK, NY 11725-1742

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
056178
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1497022925
NY
Enumeration date
11/29/2011
Last updated
05/02/2018
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