Justine Boccia, PHARM.D
Individual provider Active NPI Pharmacist · Howard Beach, NY
NPI 1508188665 · NPPES record last updated Feb 17, 2010
Key facts
- NPI
- 1508188665
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 054058 (NY)
- Practice address
- 15705 Crossbay Blvd
Howard Beach, NY 11414-2748 - Phone
- (718) 848-4507
- NPI assigned
- Feb 17, 2010
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 054058 | NY | MD | Pediatric Dentist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 054058 | NY | Yes |
Addresses
Primary practice location
15705 Crossbay Blvd
Howard Beach, NY 11414-2748
Mailing address
194 Ridge Ave
Valley Stream, NY 11581-1816
Phone (516) 808-0841
Other providers in Howard Beach, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 17, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.