Provider Demographics
NPI:1366845828
Name:PALAKODETI, SANGEETHA
Entity Type:Individual
Prefix:MRS
First Name:SANGEETHA
Middle Name:
Last Name:PALAKODETI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12500 US 15 501 N
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27517-6024
Mailing Address - Country:US
Mailing Address - Phone:919-357-9173
Mailing Address - Fax:919-357-9175
Practice Address - Street 1:12500 US 15 501 N
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27517-6024
Practice Address - Country:US
Practice Address - Phone:919-357-9173
Practice Address - Fax:919-357-9175
Is Sole Proprietor?:No
Enumeration Date:2014-09-29
Last Update Date:2014-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC19447183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist