Provider Demographics
NPI:1891097085
Name:SIVAPRAGASAM, VIMALA (PHARM D, BCPS)
Entity Type:Individual
Prefix:MS
First Name:VIMALA
Middle Name:
Last Name:SIVAPRAGASAM
Suffix:
Gender:F
Credentials:PHARM D, BCPS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:59 ROUND HILL RD
Mailing Address - Street 2:
Mailing Address - City:DOBBS FERRY
Mailing Address - State:NY
Mailing Address - Zip Code:10522-3310
Mailing Address - Country:US
Mailing Address - Phone:914-309-3424
Mailing Address - Fax:
Practice Address - Street 1:59 ROUND HILL RD
Practice Address - Street 2:
Practice Address - City:DOBBS FERRY
Practice Address - State:NY
Practice Address - Zip Code:10522-3310
Practice Address - Country:US
Practice Address - Phone:914-309-3424
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-22
Last Update Date:2010-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY043565183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist