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NPI Code Detail

MEDICARE: MRS. LATHA PAMMAL

MEDICARE: MRS. LATHA PAMMAL
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
1183500000XPharmacist040126NY

General Provider Information

NPI Number : 1881874386
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. LATHA PAMMAL
Provider Business Mailing Address
First Line : 16 FULLER ST
Second Line :
City : DIX HILLS
State : NY
Zip : 11746-6656
Country : US
Telephone Number : 631-940-5624
Fax Number : 631-549-1190
Provider Business Practice Location Address
First Line : 391 W MAIN ST
Second Line :
City : HUNTINGTON
State : NY
Zip : 11743-3203
Country : US
Telephone Number : 631-549-9592
Fax Number : 631-549-1190
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/13/2007
Last Update Date : 07/16/2010

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Directions to “ MRS. LATHA PAMMAL ” Practice Location

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