Provider Demographics
NPI:1811205206
Name:PATURI, SRI LAKSHMI
Entity Type:Individual
Prefix:MRS
First Name:SRI
Middle Name:LAKSHMI
Last Name:PATURI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1221 WATERFORD DR
Mailing Address - Street 2:
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08817-1926
Mailing Address - Country:US
Mailing Address - Phone:848-260-0243
Mailing Address - Fax:
Practice Address - Street 1:1221 WATERFORD DR
Practice Address - Street 2:
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08817
Practice Address - Country:US
Practice Address - Phone:848-230-0243
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-20
Last Update Date:2010-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI03072700183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ28RI03072700OtherPHARMACY LICENSE