Provider Demographics
NPI:1568803435
Name:CHUNDRU, SAKUNTHALA D (PHARMACIST)
Entity Type:Individual
Prefix:
First Name:SAKUNTHALA
Middle Name:D
Last Name:CHUNDRU
Suffix:
Gender:F
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:162 BRIARWOOD DR
Mailing Address - Street 2:
Mailing Address - City:NORTH BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08902-5577
Mailing Address - Country:US
Mailing Address - Phone:732-485-7545
Mailing Address - Fax:
Practice Address - Street 1:902 OAK TREE AVE STE 5
Practice Address - Street 2:
Practice Address - City:SOUTH PLAINFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07080-5137
Practice Address - Country:US
Practice Address - Phone:908-444-8185
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-08
Last Update Date:2014-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RJ04780183500000X
NJ28RI03560600183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist