Provider Demographics
NPI:1093947673
Name:INAPAKOLLA, GANESH (PHARMAIST)
Entity Type:Individual
Prefix:MR
First Name:GANESH
Middle Name:
Last Name:INAPAKOLLA
Suffix:
Gender:M
Credentials:PHARMAIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 HICKORY AVE APT E3
Mailing Address - Street 2:
Mailing Address - City:BERGENFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07621-4621
Mailing Address - Country:US
Mailing Address - Phone:336-790-8163
Mailing Address - Fax:
Practice Address - Street 1:563 E TREMONT AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10457-4655
Practice Address - Country:US
Practice Address - Phone:718-466-4700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-17
Last Update Date:2013-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC20293183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist