Provider Demographics
NPI:1194326231
Name:GOPALAKRISHNAIAH, RAMANI
Entity type:Individual
Prefix:
First Name:RAMANI
Middle Name:
Last Name:GOPALAKRISHNAIAH
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 1:11399 YORK RD
Mailing Address - Street 2:
Mailing Address - City:COCKEYSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21030-1909
Mailing Address - Country:US
Mailing Address - Phone:410-785-1065
Mailing Address - Fax:844-411-6231
Practice Address - Street 1:11399 YORK RD
Practice Address - Street 2:
Practice Address - City:COCKEYSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21030-1909
Practice Address - Country:US
Practice Address - Phone:410-785-1065
Practice Address - Fax:844-411-6231
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-05
Last Update Date:2020-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD19050183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist