Individual
BRYAN GUSTAVO LEVANO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
R.PH.I
Contact information
Practice address
259 FIRST AVE., MINEOLA, NY 11501
(516) 663-0333
Mailing address
259 1ST ST, MINEOLA, NY 11501-3957
(516) 663-0333
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
040851
NY
Other
Enumeration date
02/09/2010
Last updated
04/08/2013
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