Provider Demographics
NPI:1134470792
Name:MULPURI, NAGA ARITA
Entity Type:Individual
Prefix:MRS
First Name:NAGA
Middle Name:ARITA
Last Name:MULPURI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1326 POST RD
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06824-6012
Mailing Address - Country:US
Mailing Address - Phone:203-955-1781
Mailing Address - Fax:203-955-1782
Practice Address - Street 1:1326 POST RD
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:CT
Practice Address - Zip Code:06824-6012
Practice Address - Country:US
Practice Address - Phone:203-955-1781
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-24
Last Update Date:2019-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTPCT.0012586183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY056692OtherBOARD OF EDUCATION