Provider Demographics
NPI:1427380872
Name:KUMAR, ROMA ASHOK (BS PHARMACY)
Entity Type:Individual
Prefix:
First Name:ROMA
Middle Name:ASHOK
Last Name:KUMAR
Suffix:
Gender:F
Credentials:BS PHARMACY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1749 215TH ST
Mailing Address - Street 2:
Mailing Address - City:BAYSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11360-1728
Mailing Address - Country:US
Mailing Address - Phone:718-352-6170
Mailing Address - Fax:
Practice Address - Street 1:13222 14TH AVE
Practice Address - Street 2:
Practice Address - City:COLLEGE POINT
Practice Address - State:NY
Practice Address - Zip Code:11356-2002
Practice Address - Country:US
Practice Address - Phone:718-747-1826
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-02-10
Last Update Date:2010-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY049134-1183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist