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NPI Code Detail

MEDICARE: DR. VIDYA RANGARAJ HEBBAR PH.D., R.PH.

MEDICARE:  DR. VIDYA RANGARAJ HEBBAR  PH.D., R.PH.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist24599MD
2183500000XPharmacist054626-1NY

General Provider Information

NPI Number : 1407166861
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. VIDYA RANGARAJ HEBBAR PH.D., R.PH.
Provider Business Mailing Address
First Line : 6436 SWIMMER ROW WAY
Second Line :
City : COLUMBIA
State : MD
Zip : 21044-4962
Country : US
Telephone Number : 585-217-9442
Fax Number :
Provider Business Practice Location Address
First Line : 985 RIDGE RD
Second Line :
City : WEBSTER
State : NY
Zip : 14580-2905
Country : US
Telephone Number : 585-872-1380
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/19/2010
Last Update Date : 12/08/2016

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Directions to “ DR. VIDYA RANGARAJ HEBBAR PH.D., R.PH.” Practice Location

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