Provider Demographics
NPI:1356692685
Name:GACHETTE, RAYMOND M (PHARMD)
Entity type:Individual
Prefix:DR
First Name:RAYMOND
Middle Name:M
Last Name:GACHETTE
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24215 135TH AVE
Mailing Address - Street 2:
Mailing Address - City:ROSEDALE
Mailing Address - State:NY
Mailing Address - Zip Code:11422-1638
Mailing Address - Country:US
Mailing Address - Phone:917-560-4564
Mailing Address - Fax:
Practice Address - Street 1:24215 135TH AVE
Practice Address - Street 2:
Practice Address - City:ROSEDALE
Practice Address - State:NY
Practice Address - Zip Code:11422-1638
Practice Address - Country:US
Practice Address - Phone:917-560-4564
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-26
Last Update Date:2012-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY053503183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist