Penumetsa, Bangarraju

Penumetsa, Bangarraju is an sole proprietor health care provider with primary practice located at 11901 Jamaica Ave , Richmond Hill NY 11418-2512. He recently has only one registered license in Pharmacy Service Providers / Pharmacist, which is considered as his primary health care specialty. Penumetsa, Bangarraju can be contacted via phone (718) 847-9850.

Contact Information

Primary practice address
11901 Jamaica Ave Richmond Hill NY 11418-2512
Phone: (718) 847-9850
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Pharmacy Service Providers / Pharmacist 183500000X 049201 New York
Pharmacy Service Providers / Pharmacist 183500000X 28RI03182500 New Jersey
Pharmacy Service Providers / Pharmacist 183500000X 5302035241 Michigan
Pharmacy Service Providers / Pharmacist 183500000X 16662 Maryland

Profile Details

NPI number 1508014770
LBN Legal business name Penumetsa, Bangarraju
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 29th, 2008
Last updated Aug 29th, 2008 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1508014770 NPPES
New York MEDICAID 02646817

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