Provider Demographics
NPI:1801036678
Name:NADAKATLA, VEERA REDDY E (PHARMACIST)
Entity Type:Individual
Prefix:MR
First Name:VEERA REDDY
Middle Name:E
Last Name:NADAKATLA
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 HARRISON AVE
Mailing Address - Street 2:
Mailing Address - City:COLONIA
Mailing Address - State:NJ
Mailing Address - Zip Code:07067-2229
Mailing Address - Country:US
Mailing Address - Phone:732-581-2071
Mailing Address - Fax:
Practice Address - Street 1:102 W PLEASANT AVE
Practice Address - Street 2:
Practice Address - City:MAYWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07607-1336
Practice Address - Country:US
Practice Address - Phone:201-880-5290
Practice Address - Fax:201-880-5291
Is Sole Proprietor?:No
Enumeration Date:2009-03-05
Last Update Date:2022-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI02512100183500000X
NJ28RI02515100183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist