Healthcare Provider Details

I. General information

NPI: 1386340461
Provider Name (Legal Business Name): NATASHA BIDADI PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/01/2023
Last Update Date: 02/01/2023
Certification Date: 02/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 W 4TH ST STE 1
WILMINGTON DE
19805-3352
US

IV. Provider business mailing address

2500 W 4TH ST STE 1
WILMINGTON DE
19805-3352
US

V. Phone/Fax

Practice location:
  • Phone: 302-985-9660
  • Fax:
Mailing address:
  • Phone: 302-985-9660
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P2201X
TaxonomyAmbulatory Care Pharmacist
License NumberA1-0015863
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: