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General NPI Number Information
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NPI Number | 1225467459
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Entity Type | Individual
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Provider Name | SIDDHARTHA GULATI PHARM.D
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Gender | Male
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Dates
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Enumeration Date | 11/07/2013
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Last Update Date | 11/07/2013
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Provider Practice Location Address
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Address Line | 131 WALKER ST
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City | NEW YORK
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State | NY
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Zip | 10013-4108
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Country | US
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Telephone | 212-219-3287
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Fax | 212-369-8083
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Provider Business Mailing Address
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Address Line | 22 LUMAR RD
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City | LAWRENCEVILLE
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State | NJ
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Zip | 08648-3128
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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 | 20 056396
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License Number State | NY
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