Provider Demographics
NPI:1235421892
Name:AMIN, RONAK (PHARMD)
Entity Type:Individual
Prefix:
First Name:RONAK
Middle Name:
Last Name:AMIN
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7248 TITONKA WAY
Mailing Address - Street 2:
Mailing Address - City:DERWOOD
Mailing Address - State:MD
Mailing Address - Zip Code:20855-2673
Mailing Address - Country:US
Mailing Address - Phone:240-994-8814
Mailing Address - Fax:
Practice Address - Street 1:403 REDLAND BLVD
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-5234
Practice Address - Country:US
Practice Address - Phone:301-990-4350
Practice Address - Fax:301-990-7248
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-13
Last Update Date:2011-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD19996183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist