MEDICARE: MR. MUKUL H KINARIWALLA 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	037077-1	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	:	1275693558
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. MUKUL H KINARIWALLA R.PH

Provider Business Mailing Address
First Line	:	48 KEMI LN
Second Line	:
City	:	SAYVILLE
State	:	NY
Zip	:	11782-1150
Country	:	US
Telephone Number	:	631-563-1557
Fax Number	:

Provider Business Practice Location Address
First Line	:	239 BOYLE RD
Second Line	:
City	:	SELDEN
State	:	NY
Zip	:	11784-1955
Country	:	US
Telephone Number	:	631-698-5444
Fax Number	:

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

Provider Enumeration Date	:	12/09/2006
Last Update Date	:	01/05/2010

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