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General NPI Number Information
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NPI Number | 1790223998
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Entity Type | Individual
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Provider Name | GERO GABA SEDEDJI PHARM.D
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Gender | Female
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Dates
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Enumeration Date | 02/08/2017
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Last Update Date | 06/30/2023
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Provider Practice Location Address
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Address Line | 2920 E 38TH ST
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City | INDIANAPOLIS
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State | IN
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Zip | 46218-1518
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Country | US
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Telephone | 317-545-6167
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Fax |
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Provider Business Mailing Address
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Address Line | 2920 E 38TH ST
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City | INDIANAPOLIS
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State | IN
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Zip | 46218
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Country | US
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Telephone | 317-545-6167
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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 | 0202215474
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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 | 26028021A
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License Number State | IN
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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 | 57437
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License Number State | TX
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Taxonomy #4
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PH100002488
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License Number State | DC
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