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General NPI Number Information
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NPI Number | 1972991594
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Entity Type | Individual
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Provider Name | HARDI ANTALA PHARMD
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Gender | Male
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Dates
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Enumeration Date | 01/05/2015
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Last Update Date | 01/05/2015
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Provider Practice Location Address
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Address Line | 970 PARKWAY AVE
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City | EWING
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State | NJ
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Zip | 08618-2317
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Country | US
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Telephone | 609-882-3456
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Fax |
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Provider Business Mailing Address
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Address Line | 8 CROMWELL CT
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City | EWING
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State | NJ
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Zip | 08628-2223
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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 | 28RI03585100
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License Number State | NJ
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