Provider Demographics
NPI:1477867620
Name:DE, PARNAB (RPH)
Entity Type:Individual
Prefix:MR
First Name:PARNAB
Middle Name:
Last Name:DE
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:696 WINDING STREAM WAY UNIT 202
Mailing Address - Street 2:
Mailing Address - City:ODENTON
Mailing Address - State:MD
Mailing Address - Zip Code:21113-4510
Mailing Address - Country:US
Mailing Address - Phone:646-436-2155
Mailing Address - Fax:
Practice Address - Street 1:3250 SUPERIOR LN
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20715-1916
Practice Address - Country:US
Practice Address - Phone:301-805-1866
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-29
Last Update Date:2010-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD17058183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist