Provider Demographics
NPI:1992037659
Name:AMIN, DIPAK P (RPH)
Entity Type:Individual
Prefix:MR
First Name:DIPAK
Middle Name:P
Last Name:AMIN
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 1:1280 ST.NICHOLAS AVE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK CITY
Mailing Address - State:NY
Mailing Address - Zip Code:10033-4502
Mailing Address - Country:US
Mailing Address - Phone:212-928-8082
Mailing Address - Fax:212-928-2088
Practice Address - Street 1:1280 ST.NICHOLAS AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK CITY
Practice Address - State:NY
Practice Address - Zip Code:10033-4502
Practice Address - Country:US
Practice Address - Phone:212-928-8082
Practice Address - Fax:212-928-2088
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-05
Last Update Date:2010-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY35881183500000X
NJ28R101852200183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY35881OtherNEW YORK STATE PHARMACIST
NJ28R101852200OtherNEW JERSEY PHARMACIST