Provider Demographics
NPI:1518237742
Name:NADIPURAM, SRIKER MOHAN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:SRIKER
Middle Name:MOHAN
Last Name:NADIPURAM
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 AUTUMN LN
Mailing Address - Street 2:
Mailing Address - City:FREEHOLD
Mailing Address - State:NJ
Mailing Address - Zip Code:07728-7747
Mailing Address - Country:US
Mailing Address - Phone:732-580-4163
Mailing Address - Fax:
Practice Address - Street 1:14 AUTUMN LN
Practice Address - Street 2:
Practice Address - City:FREEHOLD
Practice Address - State:NJ
Practice Address - Zip Code:07728-7747
Practice Address - Country:US
Practice Address - Phone:732-580-4163
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-04
Last Update Date:2012-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI03375900183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist