Most Relevant Information
Provider Data
| NPI Number: | 1003246398 |
| Provider Name: | SURAJ ADIECHA |
| Entity Type: | Individual |
| Taxonomy Code: | 183500000X |
| Specialty: | Pharmacist |
| License Number: | 28RI03483400 |
Most Important Dates
| Enumeration Date: | 11/22/2013 |
| Last Updated: | 11/22/2013 |
Provider Practice Location
142 CENTRAL AVE
CLARK
NJ
070661108
Practice Location Phone/Fax
| Phone: | 7328151736 |
| Fax: |
Provider Mailing Location
142 CENTRAL AVE
CLARK
NJ
070661108
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |