Provider Demographics
NPI:1639989098
Name:ATHUNURI, RAJASEKHAR
Entity type:Individual
Prefix:MR
First Name:RAJASEKHAR
Middle Name:
Last Name:ATHUNURI
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 1:30 MAJOR RD
Mailing Address - Street 2:
Mailing Address - City:MONMOUTH JUNCTION
Mailing Address - State:NJ
Mailing Address - Zip Code:08852-2302
Mailing Address - Country:US
Mailing Address - Phone:732-647-6939
Mailing Address - Fax:
Practice Address - Street 1:30 MAJOR RD
Practice Address - Street 2:
Practice Address - City:MONMOUTH JUNCTION
Practice Address - State:NJ
Practice Address - Zip Code:08852-2302
Practice Address - Country:US
Practice Address - Phone:732-647-6939
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-08
Last Update Date:2025-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI03414300183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist