Provider Demographics
NPI:1326394024
Name:KOYA, KUNAL H (PHARM D)
Entity Type:Individual
Prefix:
First Name:KUNAL
Middle Name:H
Last Name:KOYA
Suffix:
Gender:M
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 1:903 SHERIDAN AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10451-3304
Mailing Address - Country:US
Mailing Address - Phone:718-588-0761
Mailing Address - Fax:
Practice Address - Street 1:903 SHERIDAN AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10451-3304
Practice Address - Country:US
Practice Address - Phone:718-588-0761
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-31
Last Update Date:2014-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY057038183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist