Provider Demographics
NPI:1760706881
Name:AKULA, LAVANYA (RPH)
Entity Type:Individual
Prefix:MISS
First Name:LAVANYA
Middle Name:
Last Name:AKULA
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8411 HOMELAWN ST
Mailing Address - Street 2:
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11432-2127
Mailing Address - Country:US
Mailing Address - Phone:646-642-6282
Mailing Address - Fax:718-206-4222
Practice Address - Street 1:13320 JAMAICA AVE
Practice Address - Street 2:
Practice Address - City:RICHMOND HILL
Practice Address - State:NY
Practice Address - Zip Code:11418-2617
Practice Address - Country:US
Practice Address - Phone:718-206-4653
Practice Address - Fax:718-206-4222
Is Sole Proprietor?:No
Enumeration Date:2010-03-18
Last Update Date:2010-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000068183500000X
FLPS35582183500000X
NJ28RI02785100183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist