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NPI Code Detail

MEDICARE: MR. BIJU BALAKRISHNAN RPH, B.PHARM,PHARM D

MEDICARE:  MR. BIJU  BALAKRISHNAN  RPH, B.PHARM,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
1183500000XPharmacist049974NY

General Provider Information

NPI Number : 1518101468
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. BIJU BALAKRISHNAN RPH, B.PHARM,PHARM D
Provider Business Mailing Address
First Line : 1654 RICHMOND AVE
Second Line :
City : STATEN ISLAND
State : NY
Zip : 10314-1529
Country : US
Telephone Number : 718-761-2900
Fax Number : 718-761-0146
Provider Business Practice Location Address
First Line : 1654 RICHMOND AVE
Second Line :
City : STATEN ISLAND
State : NY
Zip : 10314-1529
Country : US
Telephone Number : 718-761-2900
Fax Number : 718-761-0146
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/22/2009
Last Update Date : 04/22/2009

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Directions to “ MR. BIJU BALAKRISHNAN RPH, B.PHARM,PHARM D” Practice Location

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