Basic Information
| Provider Information | |||||||||
| NPI: | 1639492333 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MARRONE | ||||||||
| FirstName: | GASPER | ||||||||
| MiddleName: | ALFRED | ||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | B.S.PHARMACY | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8716 FLATLANDS AVENUE | ||||||||
| Address2: | |||||||||
| City: | BROOKLYN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 112363610 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7186490062 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 102-02 FLATLANDS AVENUE | ||||||||
| Address2: | |||||||||
| City: | BROOKLYN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 112363610 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7182571099 | ||||||||
| FaxNumber: | 7182575110 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/09/2010 | ||||||||
| LastUpdateDate: | 03/09/2010 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 183500000X | 21830 | NY | Y | Pharmacy Service Providers | Pharmacist |
No ID Information.