2 results for "1063886083"
Page 1 of 1
EFTA00573437.pdf
...were listed as the contact person. This is to inform you that the request was
successfully processed and the following NPI has been assigned: 1063886083.
This provider is a sole proprietor.
Practice Location:
6100 Red Hook Qtrs
Suite B-3
St Thomas, VI 00802-1348
Provider Taxonomies:
Taxonomy: 1223G0001X
License...
EFTA00521364.pdf
...Drug Schedules. (Fill in all circles that apply)
,/ Schedule II ,/ Schedule II
,,, Schedule III i Schedule III
V' Schedule IV ,/ Schedule V
Narcotic
Non Narcotic
Narcotic
Non Narcotic
Practitioner Details
National Provider ID
1063886083
* Degree
IIIIIIIMIMIIIIIIIIIIIIIIIII
* Birthdate
MEM
NM
Illia
* Graduation Year
IIIIIMI
* Professional School
COLUMBIA UNIVERSITY COLLEGE OF D...
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John Smith