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General NPI Number Information
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NPI Number | 1497045702
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Entity Type | Individual
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Provider Name | KSHITIJ JAIN B.PHARM, MBA, MS
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Gender | Male
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Dates
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Enumeration Date | 04/08/2011
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Last Update Date | 04/08/2011
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Provider Practice Location Address
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Address Line | 17069 S DUPONT HWY
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City | HARRINGTON
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State | DE
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Zip | 19952-7403
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Country | US
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Telephone | 646-236-2619
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Fax |
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Provider Business Mailing Address
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Address Line | 17069 S DUPONT HWY
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City | HARRINGTON
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State | DE
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Zip | 19952-7403
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Country | US
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Telephone | 646-236-2619
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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 | A10004127
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License Number State | DE
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