Provider Demographics
NPI:1073836425
Name:THAKER, JAYANT K (RPH)
Entity Type:Individual
Prefix:MR
First Name:JAYANT
Middle Name:K
Last Name:THAKER
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44 E POST RD
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10601-4606
Mailing Address - Country:US
Mailing Address - Phone:914-287-2410
Mailing Address - Fax:914-287-2417
Practice Address - Street 1:44 E POST RD
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10601-4606
Practice Address - Country:US
Practice Address - Phone:862-222-5390
Practice Address - Fax:914-287-2417
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-11
Last Update Date:2012-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0362621835P0018X, 183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No183500000XPharmacy Service ProvidersPharmacist