Provider Demographics
NPI:1275856031
Name:KUMARASWAMY, YECHAM (BPHARM)
Entity Type:Individual
Prefix:MR
First Name:YECHAM
Middle Name:
Last Name:KUMARASWAMY
Suffix:
Gender:M
Credentials:BPHARM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60 WINDWARD STREET
Mailing Address - Street 2:APT 206
Mailing Address - City:ST CATHARINES
Mailing Address - State:ONTARIO
Mailing Address - Zip Code:L2M4H2
Mailing Address - Country:CA
Mailing Address - Phone:905-934-9565
Mailing Address - Fax:
Practice Address - Street 1:1963 ROUTE 5&20 STREET
Practice Address - Street 2:
Practice Address - City:WATERLOO
Practice Address - State:NY
Practice Address - Zip Code:13165
Practice Address - Country:US
Practice Address - Phone:315-539-5056
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-09
Last Update Date:2010-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000217-1183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist