Provider Demographics
NPI:1013145010
Name:CHERIAN, PHILIP
Entity Type:Individual
Prefix:MR
First Name:PHILIP
Middle Name:
Last Name:CHERIAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1775 YORK AVE
Mailing Address - Street 2:SUITE 37D
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10128-6900
Mailing Address - Country:US
Mailing Address - Phone:917-674-5786
Mailing Address - Fax:
Practice Address - Street 1:1498 YORK AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10075-0703
Practice Address - Country:US
Practice Address - Phone:212-879-8990
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-29
Last Update Date:2009-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY049414-1183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist