Healthcare Provider Details

I. General information

NPI: 1215784491
Provider Name (Legal Business Name): SUBHA P VEERAPANENI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/04/2024
Last Update Date: 05/04/2024
Certification Date: 05/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

366 E CHESTNUT HILL RD
NEWARK DE
19713-3737
US

IV. Provider business mailing address

1422 BECKFORD CT
SALISBURY MD
21804-2060
US

V. Phone/Fax

Practice location:
  • Phone: 302-368-3246
  • Fax:
Mailing address:
  • Phone: 443-735-2636
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberA1-0005441
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: