Provider Demographics
NPI:1962493387
Name:VEERAMACHANENI, V RAO (RPH)
Entity Type:Individual
Prefix:
First Name:V
Middle Name:RAO
Last Name:VEERAMACHANENI
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 1:1951 FLATBUSH AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11234
Mailing Address - Country:US
Mailing Address - Phone:718-338-3434
Mailing Address - Fax:718-258-1768
Practice Address - Street 1:1951 FLATBUSH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11234-2819
Practice Address - Country:US
Practice Address - Phone:718-338-3434
Practice Address - Fax:718-258-1768
Is Sole Proprietor?:No
Enumeration Date:2005-11-03
Last Update Date:2008-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY29970183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01710407Medicaid
3370498OtherNDCAP