Individual
ASHOK PANCHOLI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
761 SUFFOLK AVE, BRENTWOOD, NY 11717-4409
(631) 273-3314
Mailing address
761 SUFFOLK AVE, BRENTWOOD, NY 11717-4409
(631) 273-3314
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
32244
NY
Other
Enumeration date
03/11/2010
Last updated
03/11/2010
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