Provider Demographics
NPI:1730465386
Name:ARYA, VIBHUTI (PHARMD)
Entity Type:Individual
Prefix:
First Name:VIBHUTI
Middle Name:
Last Name:ARYA
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 1:63 CLEARVIEW CIR
Mailing Address - Street 2:
Mailing Address - City:HOPEWELL JUNCTION
Mailing Address - State:NY
Mailing Address - Zip Code:12533-6504
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8000 UTOPIA PKWY
Practice Address - Street 2:ST. ALBERT HALL, ROOM 114
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11439-9000
Practice Address - Country:US
Practice Address - Phone:718-990-8290
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-27
Last Update Date:2011-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY054261183500000X
MN118702183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist