Provider Demographics
NPI:1407118219
Name:PANDEY, GEETHANJALI SURATKAL (RPH)
Entity Type:Individual
Prefix:MRS
First Name:GEETHANJALI
Middle Name:SURATKAL
Last Name:PANDEY
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 1:2733 E CONNELLY AVE
Mailing Address - Street 2:
Mailing Address - City:VISALIA
Mailing Address - State:CA
Mailing Address - Zip Code:93292-8034
Mailing Address - Country:US
Mailing Address - Phone:559-627-3289
Mailing Address - Fax:
Practice Address - Street 1:2733 E CONNELLY AVE
Practice Address - Street 2:
Practice Address - City:VISALIA
Practice Address - State:CA
Practice Address - Zip Code:93292
Practice Address - Country:US
Practice Address - Phone:559-627-3289
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-08
Last Update Date:2012-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACA65526183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist