Provider Demographics
NPI:1023334422
Name:KUNDU, SUBHAS C (RPH)
Entity type:Individual
Prefix:MR
First Name:SUBHAS
Middle Name:C
Last Name:KUNDU
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 1:154 EAST 174TH STREET
Mailing Address - Street 2:ASENCIO PHARMACY, INC.
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10457
Mailing Address - Country:US
Mailing Address - Phone:718-299-2416
Mailing Address - Fax:748-299-5176
Practice Address - Street 1:154 EAST 174TH STREET
Practice Address - Street 2:ASENCIO PHARMACY, INC.
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10457
Practice Address - Country:US
Practice Address - Phone:718-299-2416
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-12
Last Update Date:2010-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY047620183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist