=====================================================
General NPI Number Information
=====================================================
NPI Number | 1477885507
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MILAN C CHAUHAN PHARMACIST
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/29/2010
-----------------------------------------------------
Last Update Date | 01/29/2010
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 600 BROADWAY
-----------------------------------------------------
City | NEWBURGH
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 12550-5157
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 845-561-1771
-----------------------------------------------------
Fax | 845-562-2442
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 144 TWIN ARCH RD
-----------------------------------------------------
City | WASHINGTONVILLE
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10992-1035
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 845-561-1771
-----------------------------------------------------
Fax | 845-561-2442
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1835P0018X
-----------------------------------------------------
Taxonomy Name | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
-----------------------------------------------------
License Number | 041659
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------