Minerva, Otto Nicholas

Minerva, Otto Nicholas is an individual health care provider with primary practice located at 407 Hawkins Avenue Slater Pharmacy, Lake Ronkonkoma NY 11779-4239. He recently has only one registered license in Pharmacy Service Providers / Pharmacist, which is considered as his primary health care specialty. Minerva, Otto Nicholas can be contacted via phone (631) 588-1590.

Contact Information

Primary practice address
407 Hawkins Avenue Slater Pharmacy Lake Ronkonkoma NY 11779-4239
Phone: (631) 588-1590
Fax: (631) 588-7315
Website:
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Health care specialties

SpecialtyCodeLicense #State
Pharmacy Service Providers / Pharmacist 183500000X 025590 New York

Profile Details

NPI number 1932422144
LBN Legal business name Minerva, Otto Nicholas
Credentials R.PH.
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 3rd, 2010
Last updated Mar 16th, 2010 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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