Individual
BAKUL N MATALIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
R.PH.
Contact information
Practice address
126 E MAIN ST STE 4, EAST ISLIP, NY 11730-2600
(631) 581-9620
(631) 581-9410
Mailing address
15 TWIN CT, SAYVILLE, NY 11782-1546
(631) 567-7177
(631) 581-9410
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
031828
NY
Other
Enumeration date
01/10/2007
Last updated
07/08/2007
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