MEDICARE: MANJU ROSY JOSE 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	072546	NY

General Provider Information

NPI Number	:	1932081445
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MANJU ROSY JOSE RPH

Provider Business Mailing Address
First Line	:	816 AVENUE Z FLOOR 2
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11235-6213
Country	:	US
Telephone Number	:	309-237-9349
Fax Number	:

Provider Business Practice Location Address
First Line	:	816 AVENUE Z FLOOR 2
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11235-6213
Country	:	US
Telephone Number	:	309-237-9349
Fax Number	:

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

Provider Enumeration Date	:	07/24/2025
Last Update Date	:	07/24/2025

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