Provider Demographics
NPI:1073114732
Name:RASTOGI, RACHNA
Entity Type:Individual
Prefix:MRS
First Name:RACHNA
Middle Name:
Last Name:RASTOGI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 BRISTOL TER
Mailing Address - Street 2:
Mailing Address - City:LONG VALLEY
Mailing Address - State:NJ
Mailing Address - Zip Code:07853-3844
Mailing Address - Country:US
Mailing Address - Phone:908-399-0170
Mailing Address - Fax:
Practice Address - Street 1:1885 ROUTE 57 STE 100
Practice Address - Street 2:
Practice Address - City:HACKETTSTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07840-3477
Practice Address - Country:US
Practice Address - Phone:908-979-9651
Practice Address - Fax:908-979-9713
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-07
Last Update Date:2020-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI023840183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist