=====================================================
General NPI Number Information
=====================================================
NPI Number | 1972643922
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | AMELIA RAMDEO CHINTAMANENI PHARMACIST
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/07/2007
-----------------------------------------------------
Last Update Date | 01/16/2013
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 201 ELM ST
-----------------------------------------------------
City | YONKERS
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10701-3437
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 914-963-1062
-----------------------------------------------------
Fax | 914-963-0821
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 201 ELM ST
-----------------------------------------------------
City | YONKERS
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10701-8901
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 914-963-0186
-----------------------------------------------------
Fax | 914-963-0821
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 183500000X
-----------------------------------------------------
Taxonomy Name | Pharmacist
-----------------------------------------------------
License Number | 044208-1
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------