Provider Demographics
NPI:1861867756
Name:ALAPATI, PAVAN KUMAR (PHARMACIST)
Entity type:Individual
Prefix:
First Name:PAVAN
Middle Name:KUMAR
Last Name:ALAPATI
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2056 LEXINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10035-1732
Mailing Address - Country:US
Mailing Address - Phone:212-426-5555
Mailing Address - Fax:212-426-6166
Practice Address - Street 1:2056 LEXINGTON AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10035-1732
Practice Address - Country:US
Practice Address - Phone:212-426-5555
Practice Address - Fax:212-426-6166
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-03
Last Update Date:2015-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY056745183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist