Provider Demographics
NPI:1700064250
Name:HODARKAR, SANJAY MAHABLESHWAR (RPH)
Entity type:Individual
Prefix:MR
First Name:SANJAY
Middle Name:MAHABLESHWAR
Last Name:HODARKAR
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3830 BROADWAY AVE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10032
Mailing Address - Country:US
Mailing Address - Phone:212-927-0220
Mailing Address - Fax:212-927-8651
Practice Address - Street 1:3830 BROADWAY
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10032-1547
Practice Address - Country:US
Practice Address - Phone:212-927-0220
Practice Address - Fax:212-927-8651
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-07
Last Update Date:2008-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY039419183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist