Provider Demographics
NPI:1609239565
Name:MADADI, GEETA (PHARMACIST)
Entity Type:Individual
Prefix:
First Name:GEETA
Middle Name:
Last Name:MADADI
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 1:701 BRUNSWICK AVE
Mailing Address - Street 2:
Mailing Address - City:TRENTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08638-4123
Mailing Address - Country:US
Mailing Address - Phone:609-396-5000
Mailing Address - Fax:609-396-8806
Practice Address - Street 1:701 BRUNSWICK AVE
Practice Address - Street 2:
Practice Address - City:TRENTON
Practice Address - State:NJ
Practice Address - Zip Code:08638-4123
Practice Address - Country:US
Practice Address - Phone:609-396-5000
Practice Address - Fax:609-396-8806
Is Sole Proprietor?:No
Enumeration Date:2016-03-29
Last Update Date:2016-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI02447300183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist