Provider Demographics
NPI:1174234298
Name:EAGERS, BRENDAN (PHARMD)
Entity type:Individual
Prefix:DR
First Name:BRENDAN
Middle Name:
Last Name:EAGERS
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 LINCOLN DR
Mailing Address - Street 2:
Mailing Address - City:KINGS PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11754-3229
Mailing Address - Country:US
Mailing Address - Phone:631-521-4345
Mailing Address - Fax:
Practice Address - Street 1:2 E JERICHO TPKE
Practice Address - Street 2:
Practice Address - City:HUNTINGTON STATION
Practice Address - State:NY
Practice Address - Zip Code:11746-7302
Practice Address - Country:US
Practice Address - Phone:631-425-8871
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-09
Last Update Date:2022-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY069983183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist