MR. Otto Nicholas Minerva, R.PH.

NPI #1932422144 in Lake Ronkonkoma, New York

Provider Information

NPI Number: 1932422144
Entity Type: Individual
Name: MR. Otto Nicholas Minerva, R.PH.
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Pharmacist
Credential: R.PH.
Enumeration Date: Mar 3, 2010
Last Updated: Mar 16, 2010

Practice Location

Address: 407 HAWKINS AVENUE
Address 2: SLATER PHARMACY
City: Lake Ronkonkoma
State: New York
ZIP Code: 11779-4239
Phone: (631) 588-1590

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pharmacist	183500000X	Primary

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