Leonard Norman Rosokoff, PHARMACIST

Individual provider Active NPI Pharmacist · Tonawnada, NY

NPI 1437330149 · NPPES record last updated Nov 21, 2007

Key facts

NPI
1437330149
Entity type
Individual (NPI type 1)
Primary specialty
Pharmacist 183500000X
License
023204 (NY)
Practice address
47 Niiagara Street Tonawanda Ny 14150
Tonawnada, NY 14150
Phone
(716) 692-3932
Fax
(716) 692-7704
NPI assigned
Nov 21, 2007
Sex
Male
Sole proprietor
Yes

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
023204NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Eckerd Corporation Past Accepting new patients
Eckerd Corporation Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 023204 NY Yes

Addresses

Primary practice location

47 Niiagara Street Tonawanda Ny 14150
Tonawnada, NY 14150

Mailing address

47 Niiagara Street Tonawanda Ny 14150
Tonawnada, NY 14150
Phone (716) 692-3932

Other identifiers

IdentifierTypeStateIssuer
00730341MedicaidNY

Sources for this page

Verify at the official NPI Registry.