MEDICARE: DR. PADRAM FEJAL PHARM. D.

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	055256	NY

General Provider Information

NPI Number	:	1356642839
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PADRAM FEJAL PHARM. D.

Provider Business Mailing Address
First Line	:	1557 E 18TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11230-7201
Country	:	US
Telephone Number	:	718-376-2073
Fax Number	:

Provider Business Practice Location Address
First Line	:	1557 E 18TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11230-7201
Country	:	US
Telephone Number	:	718-376-2073
Fax Number	:

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

Provider Enumeration Date	:	11/15/2010
Last Update Date	:	03/27/2024

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