Provider Demographics
NPI:1790169449
Name:MERCHAN, CRISTIAN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:CRISTIAN
Middle Name:
Last Name:MERCHAN
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 1:362 ROCKAWAY PKWY
Mailing Address - Street 2:
Mailing Address - City:VALLEY STREAM
Mailing Address - State:NY
Mailing Address - Zip Code:11580-2684
Mailing Address - Country:US
Mailing Address - Phone:516-263-1671
Mailing Address - Fax:
Practice Address - Street 1:362 ROCKAWAY PKWY
Practice Address - Street 2:
Practice Address - City:VALLEY STREAM
Practice Address - State:NY
Practice Address - Zip Code:11580-2684
Practice Address - Country:US
Practice Address - Phone:516-263-1671
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-13
Last Update Date:2015-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0582941835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY058294OtherPHARMACY LICENSE