Provider Demographics
NPI:1073860623
Name:PAI, SUSHIL J
Entity Type:Individual
Prefix:DR
First Name:SUSHIL
Middle Name:J
Last Name:PAI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:88-20B VANWYCK EXPRESSWAY
Mailing Address - Street 2:
Mailing Address - City:RICHMOND HILL
Mailing Address - State:NY
Mailing Address - Zip Code:11418
Mailing Address - Country:US
Mailing Address - Phone:718-658-0012
Mailing Address - Fax:
Practice Address - Street 1:8245 135TH ST
Practice Address - Street 2:APT 5H
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11435-1334
Practice Address - Country:US
Practice Address - Phone:347-534-5151
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-13
Last Update Date:2012-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY057073183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist