Provider Demographics
NPI:1346478872
Name:PINNINTI, SRINIVASAN
Entity Type:Individual
Prefix:MR
First Name:SRINIVASAN
Middle Name:
Last Name:PINNINTI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 PIKES WAY
Mailing Address - Street 2:
Mailing Address - City:CHELTENHAM
Mailing Address - State:PA
Mailing Address - Zip Code:19012-1717
Mailing Address - Country:US
Mailing Address - Phone:215-379-3565
Mailing Address - Fax:215-379-3565
Practice Address - Street 1:23 PIKES WAY
Practice Address - Street 2:
Practice Address - City:CHELTENHAM
Practice Address - State:PA
Practice Address - Zip Code:19012-1717
Practice Address - Country:US
Practice Address - Phone:215-379-3565
Practice Address - Fax:215-379-3565
Is Sole Proprietor?:No
Enumeration Date:2009-06-23
Last Update Date:2009-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI02910400183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist