Provider Demographics
NPI:1558684860
Name:MANOHARAN, ARUMUGAM (RPH)
Entity Type:Individual
Prefix:
First Name:ARUMUGAM
Middle Name:
Last Name:MANOHARAN
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 1:1479 ST.NICHOLAS AV.
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10033
Mailing Address - Country:US
Mailing Address - Phone:212-923-4190
Mailing Address - Fax:212-740-0341
Practice Address - Street 1:1479 SAINT NICHOLAS AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10033-4002
Practice Address - Country:US
Practice Address - Phone:212-923-4190
Practice Address - Fax:212-740-0341
Is Sole Proprietor?:No
Enumeration Date:2010-03-02
Last Update Date:2010-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY31821183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist