Provider Demographics
NPI:1780863209
Name:PANDYA, RAJEN RASIKLAL (RPH)
Entity Type:Individual
Prefix:MR
First Name:RAJEN
Middle Name:RASIKLAL
Last Name:PANDYA
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 CARMEL HTS
Mailing Address - Street 2:
Mailing Address - City:WAPPINGERS FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:12590-3416
Mailing Address - Country:US
Mailing Address - Phone:848-473-4820
Mailing Address - Fax:845-473-5284
Practice Address - Street 1:23 CARMEL HTS
Practice Address - Street 2:
Practice Address - City:WAPPINGERS FALLS
Practice Address - State:NY
Practice Address - Zip Code:12590-3416
Practice Address - Country:US
Practice Address - Phone:845-632-1211
Practice Address - Fax:845-473-5284
Is Sole Proprietor?:No
Enumeration Date:2007-11-01
Last Update Date:2007-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY038775183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY038775OtherNEW YORK STATE LIC #