Provider Demographics
NPI:1881918050
Name:SERI, DHARMA REDDY
Entity type:Individual
Prefix:
First Name:DHARMA REDDY
Middle Name:
Last Name:SERI
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 1:924B VILLAGE DR W
Mailing Address - Street 2:
Mailing Address - City:NORTH BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08902-2826
Mailing Address - Country:US
Mailing Address - Phone:732-789-4184
Mailing Address - Fax:
Practice Address - Street 1:924B VILLAGE DR W
Practice Address - Street 2:
Practice Address - City:NORTH BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08902-2826
Practice Address - Country:US
Practice Address - Phone:732-789-4184
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-17
Last Update Date:2012-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI03200600183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist