Individual
DR. DAISY MEDRANO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
501 FOREST AVE, STATEN ISLAND, NY 10310-2502
(718) 447-1602
Mailing address
501 FOREST AVE, STATEN ISLAND, NY 10310-2502
(718) 447-1602
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
053370
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
I-053370
NYS BROAD OF PHARMACY - IMMUNIZATION PRIVILEGE
NY
Enumeration date
08/26/2009
Last updated
01/06/2015
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