Provider Demographics
NPI:1487914156
Name:KULKARNI, SURDEEP AMIT (RPH)
Entity type:Individual
Prefix:MRS
First Name:SURDEEP
Middle Name:AMIT
Last Name:KULKARNI
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 1:6 CECILIA CT
Mailing Address - Street 2:
Mailing Address - City:HOWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:07731-1458
Mailing Address - Country:US
Mailing Address - Phone:314-766-1310
Mailing Address - Fax:
Practice Address - Street 1:6 CECILIA CT
Practice Address - Street 2:
Practice Address - City:HOWELL
Practice Address - State:NJ
Practice Address - Zip Code:07731-1458
Practice Address - Country:US
Practice Address - Phone:314-766-1310
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-29
Last Update Date:2012-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RJ03246600183500000X
MI5302037157183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist