Individual
MRS. MAITHILI MANCHUKONDA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARMACIST
Contact information
Practice address
949 N 25TH ST, CAMDEN, NJ 08105-3823
(856) 963-3000
(856) 963-2000
Mailing address
15 WINDSOR RD, BELLE MEAD, NJ 08502-5848
(732) 447-8142
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
28RI03182400
NJ
Other
Enumeration date
04/21/2022
Last updated
04/21/2022
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