Provider Demographics
NPI:1760747182
Name:BHALERAO, NIKHIL A (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:NIKHIL
Middle Name:A
Last Name:BHALERAO
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 1:2873 RICHMOND AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10314-5811
Mailing Address - Country:US
Mailing Address - Phone:917-791-5852
Mailing Address - Fax:917-791-5862
Practice Address - Street 1:2873 RICHMOND AVE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10314-5811
Practice Address - Country:US
Practice Address - Phone:917-791-5852
Practice Address - Fax:917-791-5862
Is Sole Proprietor?:No
Enumeration Date:2012-07-11
Last Update Date:2013-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI03492600183500000X
NY057087183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist