MEDICARE: DIVYA SUNDRI

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	064526	NY

General Provider Information

NPI Number	:	1396624011
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DIVYA SUNDRI

Provider Business Mailing Address
First Line	:	10 MARGARET DR
Second Line	:
City	:	PLAINVIEW
State	:	NY
Zip	:	11803-5419
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1225 FRANKLIN AVE STE 100
Second Line	:
City	:	GARDEN CITY
State	:	NY
Zip	:	11530-1659
Country	:	US
Telephone Number	:	516-746-2200
Fax Number	:

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

Provider Enumeration Date	:	08/27/2025
Last Update Date	:	08/27/2025

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Directions to “ DIVYA SUNDRI ” Practice Location

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