Provider Demographics
NPI:1598214413
Name:GOSWAMI, MANISHGIRI S (PHARMD, MS, MBA)
Entity Type:Individual
Prefix:DR
First Name:MANISHGIRI
Middle Name:S
Last Name:GOSWAMI
Suffix:
Gender:M
Credentials:PHARMD, MS, MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:228 W 238TH ST
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10463-2474
Mailing Address - Country:US
Mailing Address - Phone:718-543-0800
Mailing Address - Fax:718-543-4922
Practice Address - Street 1:228 W 238TH ST
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10463-2474
Practice Address - Country:US
Practice Address - Phone:718-543-0800
Practice Address - Fax:718-543-4922
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-04
Last Update Date:2017-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY62174183500000X
NJ28RI03842600183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist