Provider Demographics
NPI:1699220657
Name:LALWANI, EKLAVYA (PHARMD)
Entity type:Individual
Prefix:
First Name:EKLAVYA
Middle Name:
Last Name:LALWANI
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:370 NEW BRUNSWICK AVE
Mailing Address - Street 2:
Mailing Address - City:FORDS
Mailing Address - State:NJ
Mailing Address - Zip Code:08863-2141
Mailing Address - Country:US
Mailing Address - Phone:732-738-1085
Mailing Address - Fax:732-738-1068
Practice Address - Street 1:370 NEW BRUNSWICK AVE
Practice Address - Street 2:
Practice Address - City:FORDS
Practice Address - State:NJ
Practice Address - Zip Code:08863-2141
Practice Address - Country:US
Practice Address - Phone:732-738-1085
Practice Address - Fax:732-738-1068
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-19
Last Update Date:2016-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI03485200183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist