Provider Demographics
NPI:1194007591
Name:KATPALLY, SABITHA
Entity Type:Individual
Prefix:
First Name:SABITHA
Middle Name:
Last Name:KATPALLY
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 1:100 STONE HILL RD
Mailing Address - Street 2:APT S -9
Mailing Address - City:SPRINGFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07081-2115
Mailing Address - Country:US
Mailing Address - Phone:908-500-9002
Mailing Address - Fax:
Practice Address - Street 1:81 PLAINFIELD AVE
Practice Address - Street 2:
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08817-3717
Practice Address - Country:US
Practice Address - Phone:732-985-2348
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-13
Last Update Date:2011-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI03198500183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist