Provider Demographics
NPI:1124267885
Name:SCANDARIATO, ROSARIO (RPH)
Entity type:Individual
Prefix:
First Name:ROSARIO
Middle Name:
Last Name:SCANDARIATO
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8516 60TH DR
Mailing Address - Street 2:
Mailing Address - City:MIDDLE VILLAGE
Mailing Address - State:NY
Mailing Address - Zip Code:11379-5432
Mailing Address - Country:US
Mailing Address - Phone:917-838-6108
Mailing Address - Fax:
Practice Address - Street 1:40 WEST 57 ST
Practice Address - Street 2:Z CHEMISTS
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019
Practice Address - Country:US
Practice Address - Phone:212-956-6000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-19
Last Update Date:2009-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY042017183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist