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General NPI Number Information
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NPI Number | 1548544208
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Entity Type | Individual
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Provider Name | RAJ NARLA R.PH
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Gender | Male
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Dates
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Enumeration Date | 09/29/2011
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Last Update Date | 09/29/2011
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Provider Practice Location Address
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Address Line | 2400 GEORGE WASHINGTON MEM HWY
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City | YORKTOWN
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State | VA
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Zip | 23693-3404
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Country | US
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Telephone | 757-867-7109
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Fax | 757-867-8271
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Provider Business Mailing Address
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Address Line | 2400 GEORGE WASHINGTON MEM HWY
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City | YORKTOWN
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State | VA
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Zip | 23693-3404
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Country | US
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Telephone | 757-867-7109
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Fax | 757-867-8271
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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 | 0202206384
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License Number State | VA
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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 | 28RI03333000
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License Number State | NJ
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Taxonomy #3
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | RP444390
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License Number State | PA
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