Provider Demographics
NPI:1962725499
Name:VALIVETI, BRAHMAJI (RPH)
Entity type:Individual
Prefix:
First Name:BRAHMAJI
Middle Name:
Last Name:VALIVETI
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 1:203 BENNINGTON TER
Mailing Address - Street 2:
Mailing Address - City:PARAMUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07652-1335
Mailing Address - Country:US
Mailing Address - Phone:917-676-1811
Mailing Address - Fax:212-234-3970
Practice Address - Street 1:5 ALFORD DR
Practice Address - Street 2:
Practice Address - City:SADDLE RIVER
Practice Address - State:NJ
Practice Address - Zip Code:07458-2631
Practice Address - Country:US
Practice Address - Phone:917-676-1811
Practice Address - Fax:212-234-3970
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-11
Last Update Date:2024-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY20 041458183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist