Provider Demographics
NPI:1134441090
Name:KINI, DEEPAK PRAKASH
Entity type:Individual
Prefix:MR
First Name:DEEPAK
Middle Name:PRAKASH
Last Name:KINI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:375 AMHERST ST
Mailing Address - Street 2:
Mailing Address - City:NASHUA
Mailing Address - State:NH
Mailing Address - Zip Code:03063-1216
Mailing Address - Country:US
Mailing Address - Phone:603-579-0615
Mailing Address - Fax:603-577-8806
Practice Address - Street 1:375 AMHERST ST
Practice Address - Street 2:
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03063-1216
Practice Address - Country:US
Practice Address - Phone:603-579-0615
Practice Address - Fax:603-577-8806
Is Sole Proprietor?:No
Enumeration Date:2010-02-19
Last Update Date:2010-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH3418183500000X
MAPH26871183500000X
MEPR5477183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist