Provider Demographics
NPI:1326659939
Name:PALATTY, NEETHA DEVASSY (RPH)
Entity Type:Individual
Prefix:
First Name:NEETHA
Middle Name:DEVASSY
Last Name:PALATTY
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2151 LEMOINE AVE
Mailing Address - Street 2:
Mailing Address - City:FORT LEE
Mailing Address - State:NJ
Mailing Address - Zip Code:07024-6041
Mailing Address - Country:US
Mailing Address - Phone:201-947-6772
Mailing Address - Fax:201-947-6525
Practice Address - Street 1:2151 LEMOINE AVE
Practice Address - Street 2:
Practice Address - City:FORT LEE
Practice Address - State:NJ
Practice Address - Zip Code:07024-6041
Practice Address - Country:US
Practice Address - Phone:201-947-6772
Practice Address - Fax:201-947-6525
Is Sole Proprietor?:No
Enumeration Date:2020-08-17
Last Update Date:2020-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI04005300183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist