Healthcare Provider Details

I. General information

NPI: 1811125537
Provider Name (Legal Business Name): VENKATESWARLU BATTINENI
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/01/2009
Last Update Date: 07/01/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

730 COURTLANDT AVE
BRONX NY
10451-7800
US

IV. Provider business mailing address

17 LEAH WAY
PARSIPPANY NJ
07054-3448
US

V. Phone/Fax

Practice location:
  • Phone: 718-292-5572
  • Fax: 718-665-5358
Mailing address:
  • Phone: 973-463-9698
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number35617
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: