Provider Demographics
NPI:1851466437
Name:ROSHAN PHARMACEUTICALS & SURGICAL INC
Entity Type:Organization
Organization Name:ROSHAN PHARMACEUTICALS & SURGICAL INC
Other - Org Name:NORTHERN WESTCHESTER RX CNTR
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER AND SP
Authorized Official - Prefix:
Authorized Official - First Name:KANTA
Authorized Official - Middle Name:
Authorized Official - Last Name:ASRANI
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:914-666-4467
Mailing Address - Street 1:19 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MOUNT KISCO
Mailing Address - State:NY
Mailing Address - Zip Code:10549-2218
Mailing Address - Country:US
Mailing Address - Phone:914-666-4467
Mailing Address - Fax:914-666-8834
Practice Address - Street 1:19 E MAIN ST
Practice Address - Street 2:
Practice Address - City:MOUNT KISCO
Practice Address - State:NY
Practice Address - Zip Code:10549-2218
Practice Address - Country:US
Practice Address - Phone:914-666-4467
Practice Address - Fax:914-666-8834
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-21
Last Update Date:2019-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
NY0226433336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2060176OtherPK
NY01569075Medicaid
NY5427930001Medicare NSC