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1023039070
SHAFFEEULAH BACCHUS
FREEPORT, NY
NPI
1023039070
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1835P1200X Pharmacist, Pharmacotherapy
(Licence: NY 050006)
Enumeration Date
2006-07-22
Last Update Date
2007-07-08
Business Address
Dr. SHAFFEEULAH BACCHUS Pharm.D.
267 W MERRICK RD
FREEPORT, NY 11520-3346
Phone number: 718-938-3274
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Mailing Address
Dr. SHAFFEEULAH BACCHUS Pharm.D.
19650 69TH AVE # 2
FRESH MEADOWS, NY 11365-4033
Phone number: 718-454-1607
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