Healthcare Provider Details

I. General information

NPI: 1588589048
Provider Name (Legal Business Name): SONAK DINESH PASTAKIA PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/12/2026
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

640 ESKENAZI AVE
INDIANAPOLIS IN
46202-5173
US

IV. Provider business mailing address

4721 N PARK AVE
INDIANAPOLIS IN
46205-1839
US

V. Phone/Fax

Practice location:
  • Phone: 765-494-4703
  • Fax:
Mailing address:
  • Phone: 215-594-9414
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number17275
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: