Provider Demographics
NPI:1235377136
Name:CHAMAKURA, SRIKANTH R (RPH)
Entity Type:Individual
Prefix:MR
First Name:SRIKANTH
Middle Name:R
Last Name:CHAMAKURA
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 1:160 LENOX AVE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10026-1319
Mailing Address - Country:US
Mailing Address - Phone:212-722-1550
Mailing Address - Fax:212-722-4461
Practice Address - Street 1:160 LENOX AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10026-1319
Practice Address - Country:US
Practice Address - Phone:212-722-1550
Practice Address - Fax:212-722-4461
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-30
Last Update Date:2009-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY048323183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist