Provider Demographics
NPI:1396835682
Name:NAIDU, MUNUSWAMY CHANDER
Entity type:Individual
Prefix:MR
First Name:MUNUSWAMY
Middle Name:CHANDER
Last Name:NAIDU
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:123 HIGHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:BERGENFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07621-3206
Mailing Address - Country:US
Mailing Address - Phone:201-384-3228
Mailing Address - Fax:
Practice Address - Street 1:123 HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:BERGENFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07621-3206
Practice Address - Country:US
Practice Address - Phone:201-384-3228
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY034851183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist