Provider Demographics
NPI:1952600272
Name:MAINI, ADARSH
Entity Type:Individual
Prefix:MR
First Name:ADARSH
Middle Name:
Last Name:MAINI
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 1:102 NAGLE AVE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10040-1401
Mailing Address - Country:US
Mailing Address - Phone:212-942-5050
Mailing Address - Fax:212-942-5856
Practice Address - Street 1:102 NAGLE AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10040-1401
Practice Address - Country:US
Practice Address - Phone:212-942-5050
Practice Address - Fax:212-942-5856
Is Sole Proprietor?:No
Enumeration Date:2011-03-25
Last Update Date:2014-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202208252183500000X
NY20 056491183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist