Individual
BRIAN SHADBOLT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
397 SUNRISE HWY W, PATCHOGUE, NY 11772-1901
(631) 654-1300
Mailing address
120A MULFORD ST, PATCHOGUE, NY 11772-8615
(516) 356-3202
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
069231
NY
Other
Enumeration date
08/02/2022
Last updated
08/02/2022
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