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General NPI Number Information
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NPI Number | 1982877031
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Entity Type | Individual
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Provider Name | SATHISH ARCOT JAISHANKERVEL MS.,RPH
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Gender | Male
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Dates
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Enumeration Date | 04/09/2008
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Last Update Date | 04/09/2008
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Provider Practice Location Address
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Address Line | 3400 MOUNTAIN RD
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City | PASADENA
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State | MD
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Zip | 21122-2021
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Country | US
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Telephone | 410-360-1509
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Fax | 410-360-4209
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Provider Business Mailing Address
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Address Line | 712 HAMMOND BRANCH RD APT 202
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City | ODENTON
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State | MD
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Zip | 21113-2480
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Country | US
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Telephone | 443-370-3954
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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 | 18432
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License Number State | MD
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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 | 0202208271
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License Number State | VA
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