MEDICARE: PUISHAN KRISTI CHU R.PH

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	048035	NY

General Provider Information

NPI Number	:	1255598421
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PUISHAN KRISTI CHU R.PH

Provider Business Mailing Address
First Line	:	7107 13TH AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11228-1605
Country	:	US
Telephone Number	:	718-633-2988
Fax Number	:

Provider Business Practice Location Address
First Line	:	7107 13TH AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11228-1605
Country	:	US
Telephone Number	:	718-633-2988
Fax Number	:

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

Provider Enumeration Date	:	05/16/2008
Last Update Date	:	07/07/2022

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