Individual
JITH PONNAMBALATH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2509 PENNSYLVANIA AVE, BALTIMORE, MD 21217-1740
(410) 225-2901
Mailing address
2509 PENNSYLVANIA AVE, BALTIMORE, MD 21217-1740
(410) 225-2901
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
18229
MD
Other
Enumeration date
09/23/2019
Last updated
09/23/2019
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