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General NPI Number Information
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NPI Number | 1639420185
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Entity Type | Individual
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Provider Name | CHARLENE DWARIKA
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Gender | Female
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Dates
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Enumeration Date | 09/24/2012
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Last Update Date | 10/04/2012
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Provider Practice Location Address
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Address Line | 591 BURNSIDE AVE
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City | INWOOD
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State | NY
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Zip | 11096-1300
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Country | US
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Telephone | 516-371-2828
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Fax |
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Provider Business Mailing Address
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Address Line | 13204 97TH AVE
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City | SOUTH RICHMOND HILL
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State | NY
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Zip | 11419-1612
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Country | US
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Telephone | 646-334-0754
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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 | 057376
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License Number State | NY
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