Provider Demographics
NPI:1790081354
Name:MUDIGINTY, KAMACHI PARIMALA (RPH)
Entity Type:Individual
Prefix:
First Name:KAMACHI PARIMALA
Middle Name:
Last Name:MUDIGINTY
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 1:6101 N OAKS BLVD
Mailing Address - Street 2:
Mailing Address - City:NORTH BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08902-2114
Mailing Address - Country:US
Mailing Address - Phone:973-960-2959
Mailing Address - Fax:
Practice Address - Street 1:6101 N OAKS BLVD
Practice Address - Street 2:
Practice Address - City:NORTH BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08902-2114
Practice Address - Country:US
Practice Address - Phone:973-960-2959
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-01-31
Last Update Date:2011-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI03130300183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist