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General NPI Number Information
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NPI Number | 1881874386
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Entity Type | Individual
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Provider Name | MRS. LATHA PAMMAL
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Gender | Female
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Dates
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Enumeration Date | 11/13/2007
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Last Update Date | 07/16/2010
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Provider Practice Location Address
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Address Line | 391 W MAIN ST
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City | HUNTINGTON
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State | NY
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Zip | 11743-3203
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Country | US
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Telephone | 631-549-9592
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Fax | 631-549-1190
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Provider Business Mailing Address
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Address Line | 16 FULLER ST
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City | DIX HILLS
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State | NY
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Zip | 11746-6656
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Country | US
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Telephone | 631-940-5624
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Fax | 631-549-1190
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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 | 040126
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License Number State | NY
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