Provider Demographics
NPI:1114091238
Name:SARKAR, SHYAMAL K (RPH)
Entity Type:Individual
Prefix:
First Name:SHYAMAL
Middle Name:K
Last Name:SARKAR
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 1:7 PINE GLEN DR
Mailing Address - Street 2:
Mailing Address - City:BLAUVELT
Mailing Address - State:NY
Mailing Address - Zip Code:10913-1150
Mailing Address - Country:US
Mailing Address - Phone:845-353-3818
Mailing Address - Fax:
Practice Address - Street 1:7 PINE GLEN DR
Practice Address - Street 2:
Practice Address - City:BLAUVELT
Practice Address - State:NY
Practice Address - Zip Code:10913-1150
Practice Address - Country:US
Practice Address - Phone:845-353-3818
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY034253183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY034253OtherNEW YORK LICENSE NUMBER