Healthcare Provider Details

I. General information

NPI: 1245802172
Provider Name (Legal Business Name): RADHA ROHATGI PHARM D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/12/2021
Last Update Date: 07/12/2021
Certification Date: 06/15/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 MICHIGAN AVE NW
WASHINGTON DC
20010-2916
US

IV. Provider business mailing address

7525 1/2 BLAIR RD NW
WASHINGTON DC
20012
US

V. Phone/Fax

Practice location:
  • Phone: 202-476-3599
  • Fax:
Mailing address:
  • Phone: 206-303-7312
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0200X
TaxonomyPediatric Pharmacist
License NumberPH100000369
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: