Healthcare Provider Details

I. General information

NPI: 1083534820
Provider Name (Legal Business Name): CHANDRESHKUMAR MANUBHAI GEVARIA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2026
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40 W 225TH ST
BRONX NY
10463-7016
US

IV. Provider business mailing address

40 W 225TH ST
BRONX NY
10463-7016
US

V. Phone/Fax

Practice location:
  • Phone: 718-733-6927
  • Fax:
Mailing address:
  • Phone: 718-733-6927
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberI073840-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: