Provider Demographics
NPI:1285636761
Name:NAVANEETHAN, VIVEK (MS, PHARM D)
Entity Type:Individual
Prefix:DR
First Name:VIVEK
Middle Name:
Last Name:NAVANEETHAN
Suffix:
Gender:M
Credentials:MS, PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 BRIDLE PATH CT
Mailing Address - Street 2:
Mailing Address - City:SICKLERVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08081-5645
Mailing Address - Country:US
Mailing Address - Phone:856-629-7807
Mailing Address - Fax:856-629-7807
Practice Address - Street 1:8 BRIDLE PATH CT
Practice Address - Street 2:
Practice Address - City:SICKLERVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08081-5645
Practice Address - Country:US
Practice Address - Phone:856-629-7807
Practice Address - Fax:856-629-7807
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI02831300183500000X
MD14402183500000X
PARP437415183500000X
DEA10003261183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist