MEDICARE: DR. KRUTI NAIK PHARMD, RPH

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
1	183500000X	Pharmacist	PH234161	MA
2	183500000X	Pharmacist	PCT.0012807	CT

General Provider Information

NPI Number	:	1417362989
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KRUTI NAIK PHARMD, RPH

Provider Business Mailing Address
First Line	:	PO BOX 36
Second Line	:
City	:	EASTHAM
State	:	MA
Zip	:	02642-0036
Country	:	US
Telephone Number	:	203-362-7263
Fax Number	:

Provider Business Practice Location Address
First Line	:	711 MAIN ST
Second Line	:
City	:	DENNIS PORT
State	:	MA
Zip	:	02639-1420
Country	:	US
Telephone Number	:	203-362-7263
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/24/2014
Last Update Date	:	06/29/2014

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