Provider Demographics
NPI:1740706423
Name:DADLANI, MANISHA PRITAM (PHARMD)
Entity type:Individual
Prefix:DR
First Name:MANISHA
Middle Name:PRITAM
Last Name:DADLANI
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1227 PIN OAK DR APT G4
Mailing Address - Street 2:
Mailing Address - City:FLOWOOD
Mailing Address - State:MS
Mailing Address - Zip Code:39232-9705
Mailing Address - Country:US
Mailing Address - Phone:662-402-1379
Mailing Address - Fax:
Practice Address - Street 1:10 RIVER BEND PL
Practice Address - Street 2:
Practice Address - City:FLOWOOD
Practice Address - State:MS
Practice Address - Zip Code:39232-9737
Practice Address - Country:US
Practice Address - Phone:601-932-2773
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-15
Last Update Date:2017-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSE-14984183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist