Provider Demographics
NPI:1487853495
Name:KELUSKAR, MADHURI A (BPHARM)
Entity Type:Individual
Prefix:MRS
First Name:MADHURI
Middle Name:A
Last Name:KELUSKAR
Suffix:
Gender:F
Credentials:BPHARM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1891 EASTERN PKWY
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11233-3290
Mailing Address - Country:US
Mailing Address - Phone:718-346-2506
Mailing Address - Fax:718-346-2534
Practice Address - Street 1:1891 EASTERN PKWY
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11233-3290
Practice Address - Country:US
Practice Address - Phone:718-346-2506
Practice Address - Fax:718-346-2534
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-11
Last Update Date:2007-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY038457183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist