Provider Demographics
NPI:1154653129
Name:BHAGROO, NARESH RANJAN (RPH)
Entity Type:Individual
Prefix:MR
First Name:NARESH
Middle Name:RANJAN
Last Name:BHAGROO
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 1:779 E GATE
Mailing Address - Street 2:
Mailing Address - City:VALLEY STREAM
Mailing Address - State:NY
Mailing Address - Zip Code:11580-1546
Mailing Address - Country:US
Mailing Address - Phone:718-789-3370
Mailing Address - Fax:
Practice Address - Street 1:49 5TH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11217-2043
Practice Address - Country:US
Practice Address - Phone:718-789-3370
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-02
Last Update Date:2010-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY038000183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist