Provider Demographics
NPI:1023142288
Name:DWARAM, PADMASREE V (M PHARM)
Entity type:Individual
Prefix:MS
First Name:PADMASREE
Middle Name:V
Last Name:DWARAM
Suffix:
Gender:F
Credentials:M PHARM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 219
Mailing Address - Street 2:
Mailing Address - City:LITTLE SILVER
Mailing Address - State:NJ
Mailing Address - Zip Code:07739-0219
Mailing Address - Country:US
Mailing Address - Phone:908-489-2775
Mailing Address - Fax:732-530-0285
Practice Address - Street 1:642 NEWMAN SPRINGS RD STE A
Practice Address - Street 2:
Practice Address - City:LINCROFT
Practice Address - State:NJ
Practice Address - Zip Code:07738-1745
Practice Address - Country:US
Practice Address - Phone:732-741-7616
Practice Address - Fax:732-530-0285
Is Sole Proprietor?:No
Enumeration Date:2007-03-16
Last Update Date:2009-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI02287800183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist