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NPI Code Detail

MEDICARE: CHANDRADAT BHAGUDAS RPH

MEDICARE: CHANDRADAT BHAGUDAS 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
1183500000XPharmacist28RI03304300NJ

General Provider Information

NPI Number : 1417551599
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHANDRADAT BHAGUDAS RPH
Provider Business Mailing Address
First Line : 30 ADELINE PL
Second Line :
City : VALLEY STREAM
State : NY
Zip : 11581-1302
Country : US
Telephone Number : 347-296-7037
Fax Number :
Provider Business Practice Location Address
First Line : 59 WASHINGTON ST
Second Line :
City : HOBOKEN
State : NJ
Zip : 07030-7383
Country : US
Telephone Number : 201-798-1889
Fax Number : 201-798-1631
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/30/2020
Last Update Date : 11/30/2020

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Directions to “ CHANDRADAT BHAGUDAS RPH” Practice Location

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