Provider Demographics
NPI:1003942236
Name:POLISETTY, RADHIKA SUNDARI (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:RADHIKA
Middle Name:SUNDARI
Last Name:POLISETTY
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2200 BENTLEY DR
Mailing Address - Street 2:APT 209
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15213-2531
Mailing Address - Country:US
Mailing Address - Phone:859-230-1427
Mailing Address - Fax:
Practice Address - Street 1:2200 BENTLEY DR
Practice Address - Street 2:APT 209
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15213-2531
Practice Address - Country:US
Practice Address - Phone:859-230-1427
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY013393183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist