Provider Demographics
NPI:1134301310
Name:PATHIL, MINI SIBI (RPH)
Entity Type:Individual
Prefix:MRS
First Name:MINI
Middle Name:SIBI
Last Name:PATHIL
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3285-QUINLAN STREET
Mailing Address - Street 2:
Mailing Address - City:YORKTOWN HEIGHT
Mailing Address - State:NY
Mailing Address - Zip Code:10598-2009
Mailing Address - Country:US
Mailing Address - Phone:914-245-1537
Mailing Address - Fax:914-526-1107
Practice Address - Street 1:3285-QUINLAN STREET
Practice Address - Street 2:
Practice Address - City:YORKTOWN HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:10598-2009
Practice Address - Country:US
Practice Address - Phone:914-245-1537
Practice Address - Fax:914-526-1107
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-29
Last Update Date:2007-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY046322183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist