Provider Demographics
NPI:1164745907
Name:RAJAN, BETCY (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:BETCY
Middle Name:
Last Name:RAJAN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2282 JERICHO TPKE
Mailing Address - Street 2:
Mailing Address - City:GARDEN CITY PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11040-4725
Mailing Address - Country:US
Mailing Address - Phone:646-573-0131
Mailing Address - Fax:
Practice Address - Street 1:2282 JERICHO TPKE
Practice Address - Street 2:
Practice Address - City:GARDEN CITY PARK
Practice Address - State:NY
Practice Address - Zip Code:11040-4725
Practice Address - Country:US
Practice Address - Phone:646-573-0131
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-08
Last Update Date:2010-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY053940183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist