Provider Demographics
NPI:1083384853
Name:BAROT, SHAILJA
Entity Type:Individual
Prefix:
First Name:SHAILJA
Middle Name:
Last Name:BAROT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SHAILJA
Other - Middle Name:BHARAT
Other - Last Name:BHAGAT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4401 AVIA PARK PL APT 314
Mailing Address - Street 2:
Mailing Address - City:HENRICO
Mailing Address - State:VA
Mailing Address - Zip Code:23233-7830
Mailing Address - Country:US
Mailing Address - Phone:714-931-4178
Mailing Address - Fax:
Practice Address - Street 1:5802 W BROAD ST
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23230-2659
Practice Address - Country:US
Practice Address - Phone:804-288-3191
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-14
Last Update Date:2021-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202219221183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist