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General NPI Number Information
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NPI Number | 1568716710
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Entity Type | Individual
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Provider Name | GITA TAVAKOLI R.PH
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Gender | Female
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Dates
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Enumeration Date | 11/08/2012
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 8901 WISCONSIN AVE
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City | BETHESDA
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State | MD
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Zip | 20889-3358
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Country | US
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Telephone | 301-295-2121
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Fax | 301-295-6136
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Provider Business Mailing Address
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Address Line | 8901 WISCONSIN AVE
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City | BETHESDA
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State | MD
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Zip | 20889-0004
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Country | US
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Telephone | 301-295-2121
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Fax | 301-295-6136
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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 | PH3257
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License Number State | DC
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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 | 0202010939
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License Number State | VA
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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 | 12874
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License Number State | MD
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