Provider Demographics
NPI:1124397849
Name:NADENDLA, NARASIMHARAO (RPH)
Entity Type:Individual
Prefix:MR
First Name:NARASIMHARAO
Middle Name:
Last Name:NADENDLA
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1024 E 14TH ST
Mailing Address - Street 2:APT#3A
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11230-4375
Mailing Address - Country:US
Mailing Address - Phone:718-758-4977
Mailing Address - Fax:
Practice Address - Street 1:964 RUTLAND RD
Practice Address - Street 2:RUTLAND PHARMACY
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11212-1544
Practice Address - Country:US
Practice Address - Phone:718-774-9613
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-12-27
Last Update Date:2016-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI03472100183500000X
PARP446114183500000X
MI5302039593183500000X
NY057668183500000X
TX57842183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist