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NPI Code Detail

MEDICARE: DR. AMARITA S RANDHAWA PHARMD

MEDICARE: DR. AMARITA S RANDHAWA PHARMD
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
1183500000XPharmacistPCT.0011741CT

General Provider Information

NPI Number : 1538412952
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. AMARITA S RANDHAWA PHARMD
Provider Business Mailing Address
First Line : 132 MAIN ST
Second Line :
City : VERNON
State : CT
Zip : 06066-5244
Country : US
Telephone Number : 860-645-9568
Fax Number :
Provider Business Practice Location Address
First Line : 475 HARTFORD RD
Second Line :
City : NEW BRITAIN
State : CT
Zip : 06053-1524
Country : US
Telephone Number : 860-348-9100
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/23/2012
Last Update Date : 10/23/2012

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