Provider Demographics
NPI:1467664748
Name:PILLAY, MANICKARAJAN (RPH)
Entity Type:Individual
Prefix:MR
First Name:MANICKARAJAN
Middle Name:
Last Name:PILLAY
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 PRESTWICK CT
Mailing Address - Street 2:
Mailing Address - City:NEW CITY
Mailing Address - State:NY
Mailing Address - Zip Code:10956-5554
Mailing Address - Country:US
Mailing Address - Phone:845-639-0141
Mailing Address - Fax:
Practice Address - Street 1:3830 BROADWAY
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10032-1547
Practice Address - Country:US
Practice Address - Phone:212-927-0220
Practice Address - Fax:212-927-8651
Is Sole Proprietor?:No
Enumeration Date:2007-05-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY037909183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist