Provider Demographics
NPI:1215334776
Name:RAJARAM, SHARMEE (RPH)
Entity type:Individual
Prefix:
First Name:SHARMEE
Middle Name:
Last Name:RAJARAM
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:SHARMEE
Other - Middle Name:
Other - Last Name:RAJASEKARAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:55 STOOTHOFF DR
Mailing Address - Street 2:
Mailing Address - City:NEW HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11040-3620
Mailing Address - Country:US
Mailing Address - Phone:917-596-7491
Mailing Address - Fax:
Practice Address - Street 1:55 STOOTHOFF DR
Practice Address - Street 2:
Practice Address - City:NEW HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:11040-3620
Practice Address - Country:US
Practice Address - Phone:917-596-7491
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-28
Last Update Date:2014-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA71977183500000X
NY056996183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist