Provider Demographics
NPI:1356654925
Name:ATTOTI, KRISHNA CHAITANYA
Entity Type:Individual
Prefix:
First Name:KRISHNA
Middle Name:CHAITANYA
Last Name:ATTOTI
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 1:345 SOMERSET ST
Mailing Address - Street 2:
Mailing Address - City:NORTH PLAINFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07060-4774
Mailing Address - Country:US
Mailing Address - Phone:908-412-9400
Mailing Address - Fax:908-757-2228
Practice Address - Street 1:345 SOMERSET ST
Practice Address - Street 2:
Practice Address - City:NORTH PLAINFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07060-4774
Practice Address - Country:US
Practice Address - Phone:908-412-9400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-23
Last Update Date:2023-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI03242200183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ28RI03242200OtherLICENSE
NJA83964376309832OtherDRIVERS LICENSE