Pavan Kumar Darisi, RPH
Individual provider Active NPI Pharmacist · Albertson, NY
NPI 1497937650 · NPPES record last updated Nov 29, 2007
Key facts
- NPI
- 1497937650
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 042682-1 (NY)
- Practice address
- 149 Wentworth Ave
Albertson, NY 11507-1739 - Phone
- (718) 361-2084
- Fax
- (718) 729-3211
- NPI assigned
- Nov 29, 2007
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 042682-1 | NY | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 042682-1 | NY | Yes |
Addresses
Primary practice location
149 Wentworth Ave
Albertson, NY 11507-1739
Mailing address
149 Ventworth Ave
Albertson, NY 11507
Phone (718) 361-2084
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 042682-1 | Other | NY | LICENSE |
Other providers in Albertson, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 29, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.