Provider Demographics
NPI:1881909232
Name:POREDDY, JHANSI RANI
Entity type:Individual
Prefix:MISS
First Name:JHANSI
Middle Name:RANI
Last Name:POREDDY
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 1:37 OLD ROUTE 22
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08809
Mailing Address - Country:US
Mailing Address - Phone:908-735-4131
Mailing Address - Fax:908-735-0461
Practice Address - Street 1:37 OLD ROUTE 22
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:NJ
Practice Address - Zip Code:08809
Practice Address - Country:US
Practice Address - Phone:908-735-4131
Practice Address - Fax:908-735-0461
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-10
Last Update Date:2010-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI02922700183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist