Provider Demographics
NPI:1215213897
Name:HOSSEINI, GITA J (RPH)
Entity Type:Individual
Prefix:MS
First Name:GITA
Middle Name:J
Last Name:HOSSEINI
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10828 KENWOOD RD
Mailing Address - Street 2:
Mailing Address - City:BLUE ASH
Mailing Address - State:OH
Mailing Address - Zip Code:45242-2812
Mailing Address - Country:US
Mailing Address - Phone:888-684-7483
Mailing Address - Fax:888-401-8557
Practice Address - Street 1:266 W CUMMINGS PARK
Practice Address - Street 2:
Practice Address - City:WOBURN
Practice Address - State:MA
Practice Address - Zip Code:01801-6346
Practice Address - Country:US
Practice Address - Phone:888-684-7483
Practice Address - Fax:888-401-8557
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-27
Last Update Date:2011-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPH23416183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist