Provider Demographics
NPI:1700215068
Name:RAGHUNAUTH, LATCHMIN (PHARMD)
Entity Type:Individual
Prefix:
First Name:LATCHMIN
Middle Name:
Last Name:RAGHUNAUTH
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9051 185TH ST
Mailing Address - Street 2:
Mailing Address - City:HOLLIS
Mailing Address - State:NY
Mailing Address - Zip Code:11423-2422
Mailing Address - Country:US
Mailing Address - Phone:347-330-1092
Mailing Address - Fax:
Practice Address - Street 1:743 AMSTERDAM AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10025-5702
Practice Address - Country:US
Practice Address - Phone:347-330-1092
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-07
Last Update Date:2013-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY053874183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist