Provider Demographics
NPI:1235367467
Name:AMIN, RUCHITA D (MD)
Entity Type:Individual
Prefix:DR
First Name:RUCHITA
Middle Name:D
Last Name:AMIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8679 CONNECTICUT ST STE A
Mailing Address - Street 2:
Mailing Address - City:MERRILLVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46410-6383
Mailing Address - Country:US
Mailing Address - Phone:219-769-9022
Mailing Address - Fax:
Practice Address - Street 1:8679 CONNECTICUT ST STE A
Practice Address - Street 2:
Practice Address - City:MERRILLVILLE
Practice Address - State:IN
Practice Address - Zip Code:46410-6383
Practice Address - Country:US
Practice Address - Phone:219-769-9022
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-25
Last Update Date:2014-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL125-055805207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology