Healthcare Provider Details

I. General information

NPI: 1154636348
Provider Name (Legal Business Name): SHILPA PULI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/11/2010
Last Update Date: 08/11/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4125 SOUTH BROAD STREET
HAMILTON NJ
08620
US

IV. Provider business mailing address

4125 SOUTH BROAD STREET
HAMILTON NJ
08620
US

V. Phone/Fax

Practice location:
  • Phone: 609-585-6500
  • Fax:
Mailing address:
  • Phone: 609-585-6500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number28RI03186800
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: