Provider Demographics
NPI:1194972778
Name:MEKA, VENKATA N (RPH)
Entity type:Individual
Prefix:MR
First Name:VENKATA
Middle Name:N
Last Name:MEKA
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121-18 POWELLS COVE BLVD UNIT#A
Mailing Address - Street 2:
Mailing Address - City:COLLEGE POINT
Mailing Address - State:NY
Mailing Address - Zip Code:11356
Mailing Address - Country:US
Mailing Address - Phone:718-964-1130
Mailing Address - Fax:
Practice Address - Street 1:2832 LINDEN BULVD
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11208-0000
Practice Address - Country:US
Practice Address - Phone:718-964-1130
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-26
Last Update Date:2013-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY035662183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY035662OtherBOARD OF PHARMACY,NY