Individual
MR. JAHAN KEIVANJAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMACIST
Contact information
Practice address
9000 LOCKHART GDN CTR, STORE # 13, ST THOMAS, VI 00802-2685
(340) 776-7098
(340) 776-8030
Mailing address
6 N CHURCH ST, GOSHEN, NY 10924-1550
(845) 237-5557
(845) 237-5558
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
036527
NY
183500000X
Pharmacist
145
VI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
06309219
—
NY
Enumeration date
06/07/2016
Last updated
02/10/2022
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