Provider Demographics
NPI:1861717621
Name:MEDITZ, WILLIAM (RPH)
Entity type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:
Last Name:MEDITZ
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2505 CARMEL AVE
Mailing Address - Street 2:SUITES 110-111
Mailing Address - City:BREWSTER
Mailing Address - State:NY
Mailing Address - Zip Code:10509-1155
Mailing Address - Country:US
Mailing Address - Phone:845-278-8200
Mailing Address - Fax:845-278-4340
Practice Address - Street 1:2505 CARMEL AVE
Practice Address - Street 2:SUITES 110-111
Practice Address - City:BREWSTER
Practice Address - State:NY
Practice Address - Zip Code:10509-1155
Practice Address - Country:US
Practice Address - Phone:845-278-8200
Practice Address - Fax:845-278-4340
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-05
Last Update Date:2010-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY041701183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist