Provider Demographics
NPI:1366764342
Name:SUBRAMANIAM, HARIDAS (RPH)
Entity type:Individual
Prefix:MR
First Name:HARIDAS
Middle Name:
Last Name:SUBRAMANIAM
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 PENNSBURY WAY
Mailing Address - Street 2:
Mailing Address - City:EAST BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08816-5264
Mailing Address - Country:US
Mailing Address - Phone:732-257-5356
Mailing Address - Fax:
Practice Address - Street 1:1 COLUMBUS PL
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-8201
Practice Address - Country:US
Practice Address - Phone:212-245-0636
Practice Address - Fax:212-307-4600
Is Sole Proprietor?:No
Enumeration Date:2010-02-18
Last Update Date:2010-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY047176183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist