MEDICARE: MR. MILIND S SUVARNAKAR PHARMACIST

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	039609	NY
2	183500000X	Pharmacist	022344	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1235115668
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. MILIND S SUVARNAKAR PHARMACIST

Provider Business Mailing Address
First Line	:	11 COTTAGE LN
Second Line	:
City	:	CLIFTON
State	:	NJ
Zip	:	07012-2103
Country	:	US
Telephone Number	:	973-495-8856
Fax Number	:	718-922-0348

Provider Business Practice Location Address
First Line	:	5105 CHURCH AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11203-3511
Country	:	US
Telephone Number	:	718-922-3400
Fax Number	:	718-922-0348

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/18/2005
Last Update Date	:	04/17/2013

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