Harrison, Jerry Anthony

Harrison, Jerry Anthony is an individual health care provider with primary practice located at 532 Union Blvd , West Islip NY 11795-3105. He recently has only one registered license in Pharmacy Service Providers / Pharmacist, which is considered as his primary health care specialty. Harrison, Jerry Anthony can be contacted via phone (631) 661-6883.

Contact Information

Primary practice address
532 Union Blvd West Islip NY 11795-3105
Phone: (631) 661-6883
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Pharmacy Service Providers / Pharmacist 183500000X 022100 New York

Profile Details

NPI number 1972783975
LBN Legal business name Harrison, Jerry Anthony
Credentials RPH
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 7th, 2007
Last updated Nov 8th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1972783975 NPPES
New York MEDICAID 01484871

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