Provider Demographics
NPI:1518287614
Name:AMIN, PREETAL RAJA (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:PREETAL
Middle Name:RAJA
Last Name:AMIN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:PREETAL
Other - Middle Name:RAJA
Other - Last Name:AMIN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DOCTOR OF PHARMACY
Mailing Address - Street 1:4535 ROSWELL RD
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30342-3100
Mailing Address - Country:US
Mailing Address - Phone:404-236-0838
Mailing Address - Fax:
Practice Address - Street 1:1200 LAKE HEARN DR NE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30319-1415
Practice Address - Country:US
Practice Address - Phone:314-972-4950
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-11
Last Update Date:2023-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH031951183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist