Provider Demographics
NPI:1174145288
Name:KUMAR, PREETHI P (PHARMD)
Entity type:Individual
Prefix:
First Name:PREETHI
Middle Name:P
Last Name:KUMAR
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2231 77TH ST APT C1
Mailing Address - Street 2:
Mailing Address - City:EAST ELMHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11370-1285
Mailing Address - Country:US
Mailing Address - Phone:516-508-2691
Mailing Address - Fax:
Practice Address - Street 1:1515 HAZEN ST
Practice Address - Street 2:
Practice Address - City:EAST ELMHURST
Practice Address - State:NY
Practice Address - Zip Code:11370-1381
Practice Address - Country:US
Practice Address - Phone:347-774-7460
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-12
Last Update Date:2020-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY058542183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist