Provider Demographics
NPI:1003316191
Name:APASANI, VENKATA PHANI (RPH)
Entity Type:Individual
Prefix:MR
First Name:VENKATA
Middle Name:PHANI
Last Name:APASANI
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 1:217 E 106TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10029-4005
Mailing Address - Country:US
Mailing Address - Phone:212-534-1939
Mailing Address - Fax:212-534-4377
Practice Address - Street 1:217 E 106TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029-4005
Practice Address - Country:US
Practice Address - Phone:212-534-1939
Practice Address - Fax:212-534-4377
Is Sole Proprietor?:No
Enumeration Date:2018-02-15
Last Update Date:2018-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI03920200183500000X
NY063827183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist