Provider Demographics
NPI:1699957969
Name:CARBO, ROOPAL (RPH)
Entity type:Individual
Prefix:MRS
First Name:ROOPAL
Middle Name:
Last Name:CARBO
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2063 BARTOW AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10475-4613
Mailing Address - Country:US
Mailing Address - Phone:718-379-8022
Mailing Address - Fax:718-379-6152
Practice Address - Street 1:2063 BARTOW AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10475-4613
Practice Address - Country:US
Practice Address - Phone:718-379-8022
Practice Address - Fax:718-379-6152
Is Sole Proprietor?:No
Enumeration Date:2007-11-28
Last Update Date:2007-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY046612183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist