Provider Demographics
NPI:1326361734
Name:PHILIP, PRIYA (PHARM D)
Entity Type:Individual
Prefix:
First Name:PRIYA
Middle Name:
Last Name:PHILIP
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 CAMDEN PL
Mailing Address - Street 2:
Mailing Address - City:NEW HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11040-3602
Mailing Address - Country:US
Mailing Address - Phone:718-297-3745
Mailing Address - Fax:
Practice Address - Street 1:13250 METROPOLITAN AVE
Practice Address - Street 2:
Practice Address - City:RICHMOND HILL
Practice Address - State:NY
Practice Address - Zip Code:11418-1948
Practice Address - Country:US
Practice Address - Phone:718-297-3745
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-12
Last Update Date:2016-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY081690183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist