Provider Demographics
NPI:1699164491
Name:ABBRUSCATO, ANTHONY (PHARMD)
Entity type:Individual
Prefix:
First Name:ANTHONY
Middle Name:
Last Name:ABBRUSCATO
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 SOUTHWOOD LN
Mailing Address - Street 2:
Mailing Address - City:NORTH BABYLON
Mailing Address - State:NY
Mailing Address - Zip Code:11703-3609
Mailing Address - Country:US
Mailing Address - Phone:631-793-0762
Mailing Address - Fax:
Practice Address - Street 1:4 SOUTHWOOD LN
Practice Address - Street 2:
Practice Address - City:NORTH BABYLON
Practice Address - State:NY
Practice Address - Zip Code:11703-3609
Practice Address - Country:US
Practice Address - Phone:631-793-0762
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-16
Last Update Date:2015-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY059588183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist