Provider Demographics
NPI:1215256805
Name:UNGER, HOWARD JAMES (RPH)
Entity type:Individual
Prefix:
First Name:HOWARD
Middle Name:JAMES
Last Name:UNGER
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 1:156 ORANGE AVE
Mailing Address - Street 2:2ND FLOOR P.O. BOX 461
Mailing Address - City:WALDEN
Mailing Address - State:NY
Mailing Address - Zip Code:12586-2029
Mailing Address - Country:US
Mailing Address - Phone:845-713-4304
Mailing Address - Fax:
Practice Address - Street 1:156 ORANGE AVE
Practice Address - Street 2:2ND FLOOR BOX 461
Practice Address - City:WALDEN
Practice Address - State:NY
Practice Address - Zip Code:12586-2029
Practice Address - Country:US
Practice Address - Phone:845-713-4304
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-23
Last Update Date:2010-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY033104-1183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist