Provider Demographics
NPI:1023340676
Name:ATHMAKURI, GIRIDHAR V (PHARMACIST)
Entity type:Individual
Prefix:MR
First Name:GIRIDHAR
Middle Name:V
Last Name:ATHMAKURI
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:430 BLEECKER ST
Mailing Address - Street 2:
Mailing Address - City:UTICA
Mailing Address - State:NY
Mailing Address - Zip Code:13501-2336
Mailing Address - Country:US
Mailing Address - Phone:315-732-6915
Mailing Address - Fax:315-732-6641
Practice Address - Street 1:430 BLEECKER ST
Practice Address - Street 2:
Practice Address - City:UTICA
Practice Address - State:NY
Practice Address - Zip Code:13501-2336
Practice Address - Country:US
Practice Address - Phone:315-732-6915
Practice Address - Fax:315-732-6641
Is Sole Proprietor?:No
Enumeration Date:2010-02-08
Last Update Date:2024-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP444355183500000X
NJ28RI03127800183500000X
NC20198183500000X
NY055496183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist