Provider Demographics
NPI:1962869636
Name:GADDE, RAKESH (PHARMD)
Entity type:Individual
Prefix:
First Name:RAKESH
Middle Name:
Last Name:GADDE
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 1:41 MADISON DR
Mailing Address - Street 2:
Mailing Address - City:PLAINSBORO
Mailing Address - State:NJ
Mailing Address - Zip Code:08536-2320
Mailing Address - Country:US
Mailing Address - Phone:609-651-1638
Mailing Address - Fax:
Practice Address - Street 1:850 AMSTERDAM AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10025-5170
Practice Address - Country:US
Practice Address - Phone:212-678-0084
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-26
Last Update Date:2016-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY061381-1183500000X
NJ28RI03646600183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist