Provider Demographics
NPI:1275814816
Name:GHETIA, AMITA (BPHARM)
Entity Type:Individual
Prefix:
First Name:AMITA
Middle Name:
Last Name:GHETIA
Suffix:
Gender:F
Credentials:BPHARM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:140 S PLAINFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:SOUTH PLAINFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07080-4046
Mailing Address - Country:US
Mailing Address - Phone:732-512-7675
Mailing Address - Fax:
Practice Address - Street 1:140 S PLAINFIELD AVE
Practice Address - Street 2:
Practice Address - City:SOUTH PLAINFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07080-4046
Practice Address - Country:US
Practice Address - Phone:732-512-7675
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-08
Last Update Date:2011-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI02618600183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist