Healthcare Provider Details

I. General information

NPI: 1700215068
Provider Name (Legal Business Name): LATCHMIN RAGHUNAUTH MONDOL PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LATCHMIN RAGHUNAUTH PHARMD

II. Dates (important events)

Enumeration Date: 11/07/2013
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4310 34TH AVE
ASTORIA NY
11101-1176
US

IV. Provider business mailing address

288 BERNICE DR
EAST MEADOW NY
11554-3503
US

V. Phone/Fax

Practice location:
  • Phone: 347-396-5888
  • Fax: 347-527-1513
Mailing address:
  • Phone: 347-330-1092
  • Fax: 347-527-1513

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number053874
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: