MEDICARE: DR. MAHIPAL SINGH RATHOD PHARMD, RPH, BCNP

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	050862	NY
2	1835N0905X	Nuclear Pharmacist	050862	NY

General Provider Information

NPI Number	:	1306018502
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MAHIPAL SINGH RATHOD PHARMD, RPH, BCNP

Provider Business Mailing Address
First Line	:	25 FAIRCHILD AVE STE 100
Second Line	:	CARDINAL HEALTH
City	:	PLAINVIEW
State	:	NY
Zip	:	11803
Country	:	US
Telephone Number	:	516-349-8001
Fax Number	:

Provider Business Practice Location Address
First Line	:	25 FAIRCHILD AVE STE 100
Second Line	:	CARDINAL HEALTH
City	:	PLAINVIEW
State	:	NY
Zip	:	11803
Country	:	US
Telephone Number	:	516-349-8001
Fax Number	:

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

Provider Enumeration Date	:	03/27/2008
Last Update Date	:	03/27/2008

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