Provider Demographics
NPI:1295050284
Name:BALCHARAN, RADESH RICHARD (PHARM D)
Entity type:Individual
Prefix:MR
First Name:RADESH
Middle Name:RICHARD
Last Name:BALCHARAN
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27 AUDUBON AVE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10032-2241
Mailing Address - Country:US
Mailing Address - Phone:646-448-4848
Mailing Address - Fax:
Practice Address - Street 1:27 AUDUBON AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10032-2241
Practice Address - Country:US
Practice Address - Phone:646-448-4848
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-01
Last Update Date:2010-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY054415183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist