Provider Demographics
NPI:1104949015
Name:PALANIAPPAN, KALYANI (RPH)
Entity type:Individual
Prefix:
First Name:KALYANI
Middle Name:
Last Name:PALANIAPPAN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24323 BELLINGHAM DR
Mailing Address - Street 2:
Mailing Address - City:NOVI
Mailing Address - State:MI
Mailing Address - Zip Code:48374-2534
Mailing Address - Country:US
Mailing Address - Phone:248-344-1966
Mailing Address - Fax:
Practice Address - Street 1:42481 W. 13 MILE RD
Practice Address - Street 2:
Practice Address - City:NOVI
Practice Address - State:MI
Practice Address - Zip Code:48377-2009
Practice Address - Country:US
Practice Address - Phone:248-668-8208
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302035150183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist