Provider Demographics
NPI:1528398468
Name:VORA, CHITANSHU ANIL
Entity Type:Individual
Prefix:
First Name:CHITANSHU
Middle Name:ANIL
Last Name:VORA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 ARBOR DR
Mailing Address - Street 2:
Mailing Address - City:HO HO KUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07423-1661
Mailing Address - Country:US
Mailing Address - Phone:917-400-2673
Mailing Address - Fax:
Practice Address - Street 1:1448 METROPOLITAN AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10462
Practice Address - Country:US
Practice Address - Phone:718-823-4344
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-12-27
Last Update Date:2019-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY051809183500000X
NY051809-1183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY051809-1OtherSTATE PHARMACIST LICENSE NUMBER