Provider Demographics
NPI:1114179579
Name:CHITTA, MOHAN SRIKANTH (PHD)
Entity Type:Individual
Prefix:DR
First Name:MOHAN
Middle Name:SRIKANTH
Last Name:CHITTA
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:540 CORAL CT
Mailing Address - Street 2:APT 3D
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23606-4341
Mailing Address - Country:US
Mailing Address - Phone:601-278-5549
Mailing Address - Fax:
Practice Address - Street 1:5601 RICHMOND RD STE B
Practice Address - Street 2:RITE AID PHARMACY
Practice Address - City:WILLIAMSBURG
Practice Address - State:VA
Practice Address - Zip Code:23188-1995
Practice Address - Country:US
Practice Address - Phone:757-565-6407
Practice Address - Fax:757-565-6443
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-16
Last Update Date:2008-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202207683183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist