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General NPI Number Information
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NPI Number | 1407166861
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Entity Type | Individual
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Provider Name | VIDYA RANGARAJ HEBBAR PH.D., R.PH.
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Gender | Female
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Dates
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Enumeration Date | 10/19/2010
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Last Update Date | 12/08/2016
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Provider Practice Location Address
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Address Line | 985 RIDGE RD
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City | WEBSTER
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State | NY
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Zip | 14580-2905
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Country | US
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Telephone | 585-872-1380
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Fax |
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Provider Business Mailing Address
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Address Line | 6436 SWIMMER ROW WAY
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City | COLUMBIA
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State | MD
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Zip | 21044-4962
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Country | US
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Telephone | 585-217-9442
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 24599
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 054626-1
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License Number State | NY
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