Provider Demographics
NPI:1225343700
Name:VASANI, KRUNAL (RPH)
Entity Type:Individual
Prefix:
First Name:KRUNAL
Middle Name:
Last Name:VASANI
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 1:1381 SAINT NICHOLAS AVE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10033-4001
Mailing Address - Country:US
Mailing Address - Phone:212-928-7263
Mailing Address - Fax:917-521-8307
Practice Address - Street 1:1381 SAINT NICHOLAS AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10033-4001
Practice Address - Country:US
Practice Address - Phone:212-928-7263
Practice Address - Fax:917-521-8307
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-09
Last Update Date:2021-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI02983300183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist