Provider Demographics
NPI:1053451096
Name:CHINTAMANENI, SRINIVAS R (PHARMACIST)
Entity Type:Individual
Prefix:
First Name:SRINIVAS
Middle Name:R
Last Name:CHINTAMANENI
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 ELM ST
Mailing Address - Street 2:
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10701-3437
Mailing Address - Country:US
Mailing Address - Phone:914-963-0186
Mailing Address - Fax:914-963-0821
Practice Address - Street 1:201 ELM ST
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10701-3437
Practice Address - Country:US
Practice Address - Phone:914-963-0186
Practice Address - Fax:914-963-0821
Is Sole Proprietor?:No
Enumeration Date:2007-02-07
Last Update Date:2013-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY047995-1183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist