Provider Demographics
NPI:1912011248
Name:RAJANI
Entity Type:Organization
Organization Name:RAJANI
Other - Org Name:NORDEN DRUGS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SP PRES
Authorized Official - Prefix:MR
Authorized Official - First Name:MEHDI
Authorized Official - Middle Name:HASAN
Authorized Official - Last Name:RAJANI
Authorized Official - Suffix:
Authorized Official - Credentials:RPH MS
Authorized Official - Phone:718-969-3314
Mailing Address - Street 1:79 01 MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11367
Mailing Address - Country:US
Mailing Address - Phone:718-969-3314
Mailing Address - Fax:718-380-3554
Practice Address - Street 1:79 01 MAIN STREET
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11367
Practice Address - Country:US
Practice Address - Phone:718-969-3314
Practice Address - Fax:718-380-3554
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-17
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY178303336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
3376894OtherNABP #
NY17830OtherSTATE LICENSE
NY00774676Medicaid
NY00774676Medicaid
NY17830OtherSTATE LICENSE