Individual
SUZANA NYANTAKTI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
45 CENTRAL AVE, CLARK, NJ 07066-1421
(732) 882-1057
Mailing address
45 CENTRAL AVE, CLARK, NJ 07066-1421
(732) 882-1057
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
28RW02285300
NJ
Other
Enumeration date
02/07/2015
Last updated
02/07/2015
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