| Doctor Name: | DR. JONATHAN SCOTT PODLASKI |
| NPI Number: | 1477876555 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PHARMD |
| License Number: | 053990 |
| Business Practice Address: | 594 Atlantic Ave East Rockaway, NY - 115181539 |
| Business Phone Number: | 5165992627 |
| Business Fax Number: | |
| Mailing Address: | 75 West Blvd, EAST ROCKAWAY |
| State: | NY |
| Postal Code: | 115182523 |
| Phone Number: | 5163951925 |
| Fax Number: | |
| NPI Enumeration Date: | 03/03/2010 |
| NPI Last Update Date: | 03/03/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1835P0018X |
| License Number: | 053990 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Pharmacy Service Providers |
| Taxonomy Classification: | Pharmacist |
| Taxonomy Specialization: | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
| Taxonomy Definition: | Pharmacist Clinician/Clinical Pharmacy Specialist is a pharmacist with additional training and an expanded scope of practice that may include prescriptive authority, therapeutic management, and disease management. |