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General NPI Number Information
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NPI Number | 1174145288
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Entity Type | Individual
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Provider Name | PREETHI P KUMAR PHARMD
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Gender | Female
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Dates
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Enumeration Date | 05/12/2020
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Last Update Date | 05/12/2020
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Provider Practice Location Address
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Address Line | 1515 HAZEN ST
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City | EAST ELMHURST
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State | NY
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Zip | 11370-1381
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Country | US
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Telephone | 347-774-7460
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Fax |
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Provider Business Mailing Address
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Address Line | 2231 77TH ST APT C1
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City | EAST ELMHURST
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State | NY
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Zip | 11370-1285
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Country | US
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Telephone | 516-508-2691
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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 | 058542
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License Number State | NY
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