MEDICARE: MR. SUBBARAYUDU NEPPALA R.PH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	0033897	NY

General Provider Information

NPI Number	:	1083843643
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. SUBBARAYUDU NEPPALA R.PH

Provider Business Mailing Address
First Line	:	1577A WESTCHESTER AVE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10472-2912
Country	:	US
Telephone Number	:	718-842-5747
Fax Number	:	718-842-6599

Provider Business Practice Location Address
First Line	:	1577A WESTCHESTER AVE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10472-2912
Country	:	US
Telephone Number	:	718-842-5747
Fax Number	:	718-842-6599

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/04/2009
Last Update Date	:	07/04/2009

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