MEDICARE: MRS. MINI SIBI PATHIL RPH

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	046322	NY

General Provider Information

NPI Number	:	1134301310
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MINI SIBI PATHIL RPH

Provider Business Mailing Address
First Line	:	3285-QUINLAN STREET
Second Line	:
City	:	YORKTOWN HEIGHT
State	:	NY
Zip	:	10598-2009
Country	:	US
Telephone Number	:	914-245-1537
Fax Number	:	914-526-1107

Provider Business Practice Location Address
First Line	:	3285-QUINLAN STREET
Second Line	:
City	:	YORKTOWN HEIGHTS
State	:	NY
Zip	:	10598-2009
Country	:	US
Telephone Number	:	914-245-1537
Fax Number	:	914-526-1107

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/29/2007
Last Update Date	:	11/29/2007

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