Provider Demographics
NPI:1558852400
Name:AIRO, MICHAEL (RPH)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:
Last Name:AIRO
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 1:1467 WEAVER ST
Mailing Address - Street 2:
Mailing Address - City:SCARSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10583-7018
Mailing Address - Country:US
Mailing Address - Phone:914-723-8558
Mailing Address - Fax:914-723-8581
Practice Address - Street 1:1467 WEAVER ST
Practice Address - Street 2:
Practice Address - City:SCARSDALE
Practice Address - State:NY
Practice Address - Zip Code:10583-7018
Practice Address - Country:US
Practice Address - Phone:914-723-8558
Practice Address - Fax:914-723-8581
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-27
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY039983183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY3339997OtherNABP