Provider Demographics
NPI:1558992339
Name:GEVARIA, NEIL NATWAR (PHARMD)
Entity Type:Individual
Prefix:
First Name:NEIL
Middle Name:NATWAR
Last Name:GEVARIA
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3419 BOSTON RD
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10469-2593
Mailing Address - Country:US
Mailing Address - Phone:718-654-6974
Mailing Address - Fax:718-882-4648
Practice Address - Street 1:3419 BOSTON RD
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10469-2593
Practice Address - Country:US
Practice Address - Phone:718-654-6974
Practice Address - Fax:718-882-4648
Is Sole Proprietor?:No
Enumeration Date:2020-01-30
Last Update Date:2020-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY066496183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist