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General NPI Number Information
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NPI Number | 1528109949
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Entity Type | Organization
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Legal Business Name | B.RADHAKRISHNAN TA ZAJACS PHARMACY
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Dates
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Enumeration Date | 02/09/2007
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Last Update Date | 04/30/2020
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Provider Practice Location Address
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Address Line | 223 GEORGE ST # 225
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City | NEW BRUNSWICK
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State | NJ
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Zip | 08901-1318
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Country | US
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Telephone | 732-545-0582
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Fax | 732-545-0583
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Provider Business Mailing Address
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Address Line | 223 GEORGE ST # 225
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City | NEW BRUNSWICK
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State | NJ
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Zip | 08901-1318
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Country | US
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Telephone | 732-545-0582
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Fax | 732-545-0583
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Authorized Official
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Title or Position | PHARMACIST MANAGER
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Name | MR. BALAKACHETTY RADHAKRISHNAN
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Credential | B.S
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Telephone | 732-545-0582
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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