Individual
BLOSSOM PADIKKALA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
19 BRADHURST AVE STE L1, HAWTHORNE, NY 10532-2139
(914) 345-0070
Mailing address
19 BRADHURST AVE STE L1, HAWTHORNE, NY 10532-2139
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
063445
NY
Other
Enumeration date
09/21/2017
Last updated
09/21/2017
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