Provider Demographics
NPI:1336488147
Name:BATAVIA, HETAL (RPH)
Entity Type:Individual
Prefix:MS
First Name:HETAL
Middle Name:
Last Name:BATAVIA
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:MS
Other - First Name:HETAL
Other - Middle Name:
Other - Last Name:SACHDE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:524 NOSTRAND AVE
Mailing Address - Street 2:THRIFT CARE PHARMACY
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11216-2012
Mailing Address - Country:US
Mailing Address - Phone:718-230-3009
Mailing Address - Fax:
Practice Address - Street 1:524 NOSTRAND AVE
Practice Address - Street 2:THRIFT CARE PHARMACY
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11216
Practice Address - Country:US
Practice Address - Phone:718-230-3009
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-14
Last Update Date:2015-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI03397400183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY057610OtherLICENSE NO. ISSUED BY NY STATE BOARD OF PHARMACY
NJ28RI03397400OtherLICENSE NO. ISSUED BY STATE BOARD OF PHARMACY