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Individual

SUDHEER MANTENA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PHD

Contact information

Practice address
750 US ROUTE 202, RINDGE, NH 03461-5615
(603) 899-6965
Mailing address
42 ROYAL CREST DR, 4, NASHUA, NH 03060-6634
(914) 374-8463

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
3621
NH
183500000X
Pharmacist
54373
TX
183500000X
Pharmacist
PH232891
MA

Other

Enumeration date
09/19/2015
Last updated
09/19/2015
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