Provider Demographics
NPI:1417109745
Name:APPALANENI, RAJENDRA P
Entity Type:Individual
Prefix:
First Name:RAJENDRA
Middle Name:P
Last Name:APPALANENI
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 1:62 STONEY RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:SADDLE RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:07458-2510
Mailing Address - Country:US
Mailing Address - Phone:917-568-9000
Mailing Address - Fax:
Practice Address - Street 1:62 STONEY RIDGE RD
Practice Address - Street 2:
Practice Address - City:SADDLE RIVER
Practice Address - State:NJ
Practice Address - Zip Code:07458-2510
Practice Address - Country:US
Practice Address - Phone:917-568-9000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-17
Last Update Date:2020-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT9648183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist