Provider Demographics
NPI:1043502297
Name:BIRY, MUNNI (RPH)
Entity Type:Individual
Prefix:MRS
First Name:MUNNI
Middle Name:
Last Name:BIRY
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 1:2457 FOX STREAM LN
Mailing Address - Street 2:
Mailing Address - City:HERNDON
Mailing Address - State:VA
Mailing Address - Zip Code:20171-3049
Mailing Address - Country:US
Mailing Address - Phone:703-793-9013
Mailing Address - Fax:
Practice Address - Street 1:25401 EASTERN MARKETPLACE PLZ
Practice Address - Street 2:STE 150
Practice Address - City:CHANTILLY
Practice Address - State:VA
Practice Address - Zip Code:20152-5782
Practice Address - Country:US
Practice Address - Phone:703-722-2389
Practice Address - Fax:703-327-0382
Is Sole Proprietor?:No
Enumeration Date:2011-05-06
Last Update Date:2011-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202207662183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist