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General NPI Number Information
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NPI Number | 1205152683
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Entity Type | Individual
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Provider Name | NARENDRA B VUTLA PHARMD
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Gender | Male
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Dates
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Enumeration Date | 04/11/2010
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Last Update Date | 11/09/2010
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Provider Practice Location Address
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Address Line | 39 N PLANK RD
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City | NEWBURGH
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State | NY
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Zip | 12550-2118
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Country | US
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Telephone | 845-561-3784
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Fax | 845-561-2961
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Provider Business Mailing Address
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Address Line | 39 N PLANK RD
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City | NEWBURGH
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State | NY
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Zip | 12550-2118
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Country | US
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Telephone | 845-561-3784
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Fax | 845-561-2961
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 28RI03187800
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 054451
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 1835P0018X
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Taxonomy Name | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
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License Number | 054451
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License Number State | NY
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