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General NPI Number Information
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NPI Number | 1447615240
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Entity Type | Individual
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Provider Name | SUDHA S MOKKAPATI PHARMD
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Gender | Female
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Dates
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Enumeration Date | 12/21/2015
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Last Update Date | 12/21/2015
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Provider Practice Location Address
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Address Line | 6201 GERMANTOWN AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19144-2033
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Country | US
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Telephone | 215-713-2695
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Fax |
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Provider Business Mailing Address
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Address Line | 4720 YORKSHIRE DR
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City | MACUNGIE
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State | PA
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Zip | 18062-8256
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Country | US
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Telephone | 601-504-2353
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Fax |
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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 | RP450012
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License Number State | PA
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