Provider Demographics
NPI:1205151784
Name:SCHORR, JASON (RPH)
Entity type:Individual
Prefix:MR
First Name:JASON
Middle Name:
Last Name:SCHORR
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:MR
Other - First Name:JAY
Other - Middle Name:
Other - Last Name:SCHORR
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RPH
Mailing Address - Street 1:6742 213TH ST
Mailing Address - Street 2:
Mailing Address - City:OAKLAND GARDENS
Mailing Address - State:NY
Mailing Address - Zip Code:11364-2510
Mailing Address - Country:US
Mailing Address - Phone:718-229-0410
Mailing Address - Fax:
Practice Address - Street 1:67-42 213TH STREET
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:11364
Practice Address - Country:US
Practice Address - Phone:718-229-0410
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-29
Last Update Date:2010-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY031974183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist