Individual
DR. MICHAEL SIMON CUCCI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARM.D., RPH
Contact information
Practice address
50 ROUTE 25A, ST CATHERINE OF SIENA MEDICAL CENTER - DEPT OF PHARMACY, SMITHTOWN, NY 11787-1348
(631) 862-3020
(631) 862-3732
Mailing address
2947 BAYVIEW AVE, WANTAGH, NY 11793-4322
(516) 641-7046
Taxonomy
Speciality
Code
Description
License number
State
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Primary
058090
NY
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
I058090
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
058090
NYS BOARD OF PHARMACY LICENSURE (PHARMACIST)
NY
01
—
I058090
NYS BOARD OF PHARMACY LICENSURE (PHARMACIST)
NY
Enumeration date
07/10/2013
Last updated
08/27/2020
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