Provider Demographics
NPI:1558634758
Name:RAO, RAJIV N (RPH)
Entity Type:Individual
Prefix:MR
First Name:RAJIV
Middle Name:N
Last Name:RAO
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 1:17239 FIVE POINTS SQ
Mailing Address - Street 2:
Mailing Address - City:LEWES
Mailing Address - State:DE
Mailing Address - Zip Code:19958-1699
Mailing Address - Country:US
Mailing Address - Phone:302-644-7840
Mailing Address - Fax:302-644-7844
Practice Address - Street 1:17239 FIVE POINTS SQ
Practice Address - Street 2:
Practice Address - City:LEWES
Practice Address - State:DE
Practice Address - Zip Code:19958-1699
Practice Address - Country:US
Practice Address - Phone:302-644-7840
Practice Address - Fax:302-644-7844
Is Sole Proprietor?:No
Enumeration Date:2012-02-17
Last Update Date:2012-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEA1-0002201183500000X
MD11282183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist