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Individual

DR. TANAPONG PANTASRI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PHARM.D

Contact information

Practice address
7316 ROOSEVELT AVE, JACKSON HEIGHTS, NY 11372-6336
(917) 832-6035
Mailing address
7316 ROOSEVELT AVE, JACKSON HEIGHTS, NY 11372-6336
(917) 832-6035
(917) 832-6426

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
066612
NY
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Primary
066612
NY

Other

Enumeration date
07/11/2019
Last updated
05/30/2020
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