Provider Demographics
NPI:1730455650
Name:EMMADI, SANDHYA RANI
Entity type:Individual
Prefix:
First Name:SANDHYA
Middle Name:RANI
Last Name:EMMADI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1367 BROOKSTONE DR
Mailing Address - Street 2:
Mailing Address - City:GARNET VALLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19060-1745
Mailing Address - Country:US
Mailing Address - Phone:610-563-4940
Mailing Address - Fax:
Practice Address - Street 1:1367 BROOKSTONE DR
Practice Address - Street 2:
Practice Address - City:GARNET VALLEY
Practice Address - State:PA
Practice Address - Zip Code:19060-1745
Practice Address - Country:US
Practice Address - Phone:610-563-4940
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-25
Last Update Date:2012-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY056662183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist