MEDICARE: AAUSADH INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	019679	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1023197530
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AAUSADH INC

Provider Business Mailing Address
First Line	:	4615 5TH AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11220-1254
Country	:	US
Telephone Number	:	718-972-2780
Fax Number	:	718-435-8081

Provider Business Practice Location Address
First Line	:	4615 5TH AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11220-1254
Country	:	US
Telephone Number	:	718-972-2780
Fax Number	:	718-435-8081

Authorized Official
Title or Position	:	CHIEF PHARMACIST
Name	:	PUNITA J. KOTHARI
Credential	:	RPH
Telephone Number	:	718-972-2780

Provider Enumeration Date	:	11/03/2006
Last Update Date	:	02/04/2008

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Directions to “AAUSADH INC ” Practice Location

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