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Individual

MR. BAKTHAVATSALU DHAMA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
RPH

Contact information

Practice address
12501 101ST AVE, SOUTH RICHMOND HILL, NY 11419-1411
(718) 849-7300
(718) 785-3333
Mailing address
12501 101ST AVE, SOUTH RICHMOND HILL, NY 11419-1411
(718) 849-7300
(718) 785-3333

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
039845
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02617807
NY
Enumeration date
03/19/2010
Last updated
03/19/2010
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