Individual
MRS. BANANI DUTTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.PH
Contact information
Practice address
107-45 GUY R. BREWER BLVD, JAMAICA, NY 11433-2351
(718) 297-6500
(718) 297-6501
Mailing address
107-45 GUY R. BREWER BLVD, JAMAICA, NY 11433
(718) 297-6500
(718) 297-6501
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
034472
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01090633
—
NY
Enumeration date
10/17/2008
Last updated
10/17/2008
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