Individual
PRAJAKTA AMOL FULAMBARKAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
19360 COMPASS CREEK PKWY, LEESBURG, VA 20175-5445
(703) 779-0164
Mailing address
22440 CONSERVANCY DR, ASHBURN, VA 20148-8065
(703) 297-9703
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
0202209060
VA
Other
Enumeration date
11/03/2020
Last updated
11/03/2020
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