Most Relevant Information
Provider Data
| NPI Number: | 1003588518 |
| Provider Name: | DEEPA JAYANTI SHIWCHARAN PHARMD |
| Entity Type: | Individual |
| Taxonomy Code: | 183500000X |
| Specialty: | Pharmacist |
| License Number: | 068179 |
Most Important Dates
| Enumeration Date: | 10/03/2021 |
| Last Updated: | 10/03/2021 |
Provider Practice Location
225 FOREST AVE
GLEN COVE
NY
11542
Practice Location Phone/Fax
| Phone: | 5167591201 |
| Fax: |
Provider Mailing Location
95-53 111TH ST.
RICHMOND HILL
NY
11419
Provider Mailing Phone/Fax
| Phone: | 7184801418 |
| Fax: |