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General NPI Number Information
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NPI Number | 1689183048
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Entity Type | Individual
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Provider Name | KIRTANA SUBRAMANIAN RPH
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Gender | Female
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Dates
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Enumeration Date | 09/28/2017
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Last Update Date | 09/28/2017
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Provider Practice Location Address
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Address Line | 521 S BROAD ST
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City | TRENTON
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State | NJ
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Zip | 08611-1819
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Country | US
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Telephone | 312-316-2792
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Fax |
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Provider Business Mailing Address
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Address Line | 208 FOUNTAYNE LN
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City | LAWRENCEVILLE
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State | NJ
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Zip | 08648-2677
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Country | US
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Telephone |
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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 | 28RI03550900
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License Number State | NJ
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