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General NPI Number Information
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NPI Number | 1710598636
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Entity Type | Individual
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Provider Name | CHETRA RATH PHARMD
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Gender | Male
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Dates
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Enumeration Date | 08/13/2020
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Last Update Date | 08/13/2020
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Provider Practice Location Address
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Address Line |
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City |
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State |
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Zip |
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Country | US
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Telephone |
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Fax |
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Provider Business Mailing Address
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Address Line | P.O. Box 1213
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City | Lowell
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State | Ma
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Zip | 01853
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Country | US
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Telephone | 9999999999
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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 | PH239636
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License Number State | MA
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