Provider Demographics
NPI:1205083201
Name:VENIGALLA, ARUNAREKHA (PHARMACIST)
Entity type:Individual
Prefix:MRS
First Name:ARUNAREKHA
Middle Name:
Last Name:VENIGALLA
Suffix:
Gender:F
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8285 JERICHO TPKE
Mailing Address - Street 2:
Mailing Address - City:WOODBURY
Mailing Address - State:NY
Mailing Address - Zip Code:11797-1807
Mailing Address - Country:US
Mailing Address - Phone:516-367-9030
Mailing Address - Fax:
Practice Address - Street 1:8285 JERICHO TPKE
Practice Address - Street 2:
Practice Address - City:WOODBURY
Practice Address - State:NY
Practice Address - Zip Code:11797-1807
Practice Address - Country:US
Practice Address - Phone:516-367-9030
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-20
Last Update Date:2022-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY044751183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY044751OtherBOARD OF PHARMACY