Provider Demographics
NPI:1861621427
Name:NAIR, VIDYA SUNIL (RPH)
Entity type:Individual
Prefix:MRS
First Name:VIDYA
Middle Name:SUNIL
Last Name:NAIR
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 1:114 LOWELL AVE
Mailing Address - Street 2:
Mailing Address - City:NEW HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11040-2812
Mailing Address - Country:US
Mailing Address - Phone:516-437-0785
Mailing Address - Fax:
Practice Address - Street 1:114 LOWELL AVE
Practice Address - Street 2:
Practice Address - City:NEW HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:11040-2812
Practice Address - Country:US
Practice Address - Phone:516-437-0785
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-03
Last Update Date:2009-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY051068183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist