Provider Demographics
NPI:1891837894
Name:KONDOOR, RAJESHWAR (RPH)
Entity Type:Individual
Prefix:
First Name:RAJESHWAR
Middle Name:
Last Name:KONDOOR
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 1:1908 DEERCREEK DRIVE
Mailing Address - Street 2:
Mailing Address - City:PLAINSBORO
Mailing Address - State:NJ
Mailing Address - Zip Code:08536
Mailing Address - Country:US
Mailing Address - Phone:732-475-2757
Mailing Address - Fax:212-923-8509
Practice Address - Street 1:4027 BROADWAY
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10032-1536
Practice Address - Country:US
Practice Address - Phone:212-923-6000
Practice Address - Fax:212-923-8509
Is Sole Proprietor?:No
Enumeration Date:2007-02-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY050652183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist