Individual
KRISHNA SURAPANENI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
747 IRVINGTON AVENUE, MAPLEWOOD, NJ 07040
(973) 762-2700
Mailing address
747 IRVINGTON AVENUE, MAPLEWOOD, NJ 07040
(973) 762-2700
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
28RI03202500
NJ
Other
Enumeration date
05/10/2017
Last updated
05/10/2017
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