Provider Demographics
NPI:1821311200
Name:MARELLA, VENKATESWARLU (RPH)
Entity Type:Individual
Prefix:
First Name:VENKATESWARLU
Middle Name:
Last Name:MARELLA
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2718 8TH AVE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10030-3706
Mailing Address - Country:US
Mailing Address - Phone:212-283-6228
Mailing Address - Fax:212-281-2635
Practice Address - Street 1:2718 8TH AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10030-3706
Practice Address - Country:US
Practice Address - Phone:212-283-6228
Practice Address - Fax:212-281-2635
Is Sole Proprietor?:No
Enumeration Date:2010-03-12
Last Update Date:2010-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY33600183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist