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General NPI Number Information
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NPI Number | 1093360463
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Entity Type | Individual
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Provider Name | PRANEETA NAGRAJ PHARMD
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Gender | Female
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Dates
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Enumeration Date | 08/02/2019
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Last Update Date | 08/02/2019
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Provider Practice Location Address
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Address Line | 246 8TH AVE
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City | NEW YORK
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State | NY
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Zip | 10011-1646
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Country | US
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Telephone | 212-243-4987
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Fax |
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Provider Business Mailing Address
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Address Line | 2207 36TH ST APT 2
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City | ASTORIA
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State | NY
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Zip | 11105-2200
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 0619771
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License Number State | NY
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