Healthcare Provider Details

I. General information

NPI: 1306136619
Provider Name (Legal Business Name): MR. JAGI CHHUGANI
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/08/2011
Last Update Date: 07/05/2024
Certification Date: 07/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2021 LEXINGTON AVE FRNT 3
NEW YORK NY
10035-2223
US

IV. Provider business mailing address

2021 LEXINGTON AVE FRNT 3
NEW YORK NY
10035-2223
US

V. Phone/Fax

Practice location:
  • Phone: 212-426-5555
  • Fax: 212-426-6166
Mailing address:
  • Phone: 212-426-5555
  • Fax: 212-426-6166

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number035755
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: