Provider Demographics
NPI:1710235981
Name:KARANI, MAMTA V (PHARMD, BCPS)
Entity Type:Individual
Prefix:DR
First Name:MAMTA
Middle Name:V
Last Name:KARANI
Suffix:
Gender:F
Credentials:PHARMD, BCPS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4770 BUFORD HWY
Mailing Address - Street 2:MS-F62
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30341-3717
Mailing Address - Country:US
Mailing Address - Phone:770-488-3520
Mailing Address - Fax:
Practice Address - Street 1:4770 BUFORD HWY
Practice Address - Street 2:MS-F62
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30341-3717
Practice Address - Country:US
Practice Address - Phone:770-488-3520
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-20
Last Update Date:2016-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI03500400183500000X
MD20795183500000X
GARPH0289961835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy
No183500000XPharmacy Service ProvidersPharmacist