Provider Demographics
NPI:1770922858
Name:PADIGALA, MADHAVI
Entity type:Individual
Prefix:
First Name:MADHAVI
Middle Name:
Last Name:PADIGALA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:209 APPLEGARTH RD STE 105
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:NJ
Mailing Address - Zip Code:08831-3843
Mailing Address - Country:US
Mailing Address - Phone:609-642-8208
Mailing Address - Fax:609-642-8396
Practice Address - Street 1:209 APPLEGARTH RD STE 105
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:NJ
Practice Address - Zip Code:08831-3843
Practice Address - Country:US
Practice Address - Phone:609-642-8208
Practice Address - Fax:609-642-8396
Is Sole Proprietor?:No
Enumeration Date:2013-06-21
Last Update Date:2018-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI03122800183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist