Provider Demographics
NPI:1497089379
Name:GEORGE, CIJU (PHARM D)
Entity Type:Individual
Prefix:MRS
First Name:CIJU
Middle Name:
Last Name:GEORGE
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 1:1300 FRANKLIN AVE
Mailing Address - Street 2:
Mailing Address - City:GARDEN CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11530-1886
Mailing Address - Country:US
Mailing Address - Phone:516-535-1201
Mailing Address - Fax:516-535-1207
Practice Address - Street 1:1300 FRANKLIN AVE
Practice Address - Street 2:
Practice Address - City:GARDEN CITY
Practice Address - State:NY
Practice Address - Zip Code:11530-1886
Practice Address - Country:US
Practice Address - Phone:516-535-1201
Practice Address - Fax:516-535-1207
Is Sole Proprietor?:No
Enumeration Date:2009-09-25
Last Update Date:2010-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY051270183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist