Provider Demographics
NPI:1275056673
Name:REKHI, VIJAYANT
Entity Type:Individual
Prefix:
First Name:VIJAYANT
Middle Name:
Last Name:REKHI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:203 S BROADWAY
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:NH
Mailing Address - Zip Code:03079-3377
Mailing Address - Country:US
Mailing Address - Phone:603-870-0083
Mailing Address - Fax:
Practice Address - Street 1:203 S BROADWAY
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:NH
Practice Address - Zip Code:03079-3377
Practice Address - Country:US
Practice Address - Phone:603-870-0083
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-18
Last Update Date:2020-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIRPH05725183500000X
NHPHCY-04413183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist