MEDICARE: MR. THURUTHEL JACOB KURIAN 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
1	183500000X	Pharmacist	044319	NY

General Provider Information

NPI Number	:	1891932612
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. THURUTHEL JACOB KURIAN RPH

Provider Business Mailing Address
First Line	:	71 S HARRISON AVE
Second Line	:
City	:	CONGERS
State	:	NY
Zip	:	10920-2213
Country	:	US
Telephone Number	:	845-268-0080
Fax Number	:	718-399-6895

Provider Business Practice Location Address
First Line	:	280 NOSTRAND AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11205-4927
Country	:	US
Telephone Number	:	718-623-9533
Fax Number	:	718-399-6895

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

Provider Enumeration Date	:	01/15/2009
Last Update Date	:	01/15/2009

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