Individual
MRS. DARCIE A PHILLIPS SIVACEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2305 JERICHO TPKE, GARDEN CITY PARK, NY 11040-4709
(516) 741-1510
Mailing address
24 GODFREY AVE, BAYVILLE, NY 11709-2702
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
046634
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02770785
—
NY
01
—
046634
NEW YORK STATE
—
Enumeration date
02/25/2008
Last updated
02/25/2008
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