Provider Demographics
NPI:1093999559
Name:AMIN, VAISHALI HIMANSHU
Entity Type:Individual
Prefix:
First Name:VAISHALI
Middle Name:HIMANSHU
Last Name:AMIN
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 1:5624 BALTIMORE NATIONAL PIKE
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21228-1401
Mailing Address - Country:US
Mailing Address - Phone:410-719-7608
Mailing Address - Fax:410-719-0400
Practice Address - Street 1:5624 BALTIMORE NATIONAL PIKE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21228-1401
Practice Address - Country:US
Practice Address - Phone:410-719-7608
Practice Address - Fax:410-719-0400
Is Sole Proprietor?:No
Enumeration Date:2007-12-19
Last Update Date:2007-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD16474183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist