Provider Demographics
NPI:1275134686
Name:SAHA, CHIRANJIT KUMAR (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:CHIRANJIT
Middle Name:KUMAR
Last Name:SAHA
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6128 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:WOODSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11377-2152
Mailing Address - Country:US
Mailing Address - Phone:917-744-2006
Mailing Address - Fax:
Practice Address - Street 1:6128 BROADWAY
Practice Address - Street 2:
Practice Address - City:WOODSIDE
Practice Address - State:NY
Practice Address - Zip Code:11377-2152
Practice Address - Country:US
Practice Address - Phone:917-744-2006
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-03
Last Update Date:2020-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY067201183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist