Provider Demographics
NPI:1275856015
Name:PAREPALLI, RADHAKRISHNA (M PHARM)
Entity Type:Individual
Prefix:
First Name:RADHAKRISHNA
Middle Name:
Last Name:PAREPALLI
Suffix:
Gender:M
Credentials:M PHARM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2319 COURT NORTH DR
Mailing Address - Street 2:
Mailing Address - City:MELVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11747-8147
Mailing Address - Country:US
Mailing Address - Phone:631-501-7673
Mailing Address - Fax:
Practice Address - Street 1:2315 MIDDLE COUNTRY RD
Practice Address - Street 2:
Practice Address - City:CENTEREACH
Practice Address - State:NY
Practice Address - Zip Code:11720-3531
Practice Address - Country:US
Practice Address - Phone:631-981-3344
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-08
Last Update Date:2010-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY041632183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist