Provider Demographics
NPI:1114438850
Name:CHALUVADI, VENUMADHAV
Entity Type:Individual
Prefix:
First Name:VENUMADHAV
Middle Name:
Last Name:CHALUVADI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 CHATHAM CT
Mailing Address - Street 2:
Mailing Address - City:UNIONVILLE
Mailing Address - State:CT
Mailing Address - Zip Code:06085-1188
Mailing Address - Country:US
Mailing Address - Phone:973-885-2793
Mailing Address - Fax:860-760-6270
Practice Address - Street 1:344 N MAIN ST
Practice Address - Street 2:
Practice Address - City:WEST HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06117-2526
Practice Address - Country:US
Practice Address - Phone:860-236-3564
Practice Address - Fax:860-236-7053
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-21
Last Update Date:2017-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT11490183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist